Provider Demographics
NPI:1649533209
Name:WALKER, CHARNELLE
Entity type:Individual
Prefix:
First Name:CHARNELLE
Middle Name:
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 1:812 JEFFERSON ST NW
Mailing Address - Street 2:APT 201
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2946
Mailing Address - Country:US
Mailing Address - Phone:202-200-7894
Mailing Address - Fax:
Practice Address - Street 1:812 JEFFERSON ST NW
Practice Address - Street 2:APT 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2946
Practice Address - Country:US
Practice Address - Phone:202-200-7894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide