Provider Demographics
NPI:1538940820
Name:WALKER, DONMONIQUE NICOLE
Entity type:Individual
Prefix:
First Name:DONMONIQUE
Middle Name:NICOLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 KINKADE CT
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29805-7846
Mailing Address - Country:US
Mailing Address - Phone:803-646-7690
Mailing Address - Fax:
Practice Address - Street 1:551 KINKADE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29805-7846
Practice Address - Country:US
Practice Address - Phone:803-646-7690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011696791347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle