Provider Demographics
NPI:1588714885
Name:WALKER, DEBORAH ANN (LVN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 N 11TH ST
Mailing Address - Street 2:P2300
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1500
Mailing Address - Country:US
Mailing Address - Phone:409-892-4100
Mailing Address - Fax:409-892-4108
Practice Address - Street 1:755 N 11TH ST
Practice Address - Street 2:P2300
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702
Practice Address - Country:US
Practice Address - Phone:409-892-4100
Practice Address - Fax:409-892-4108
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139273164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139273OtherNURSING LICENSE