Provider Demographics
NPI:1659163087
Name:WALKER, FARESIA L
Entity type:Individual
Prefix:MISS
First Name:FARESIA
Middle Name:L
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 1:195 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-6349
Mailing Address - Country:US
Mailing Address - Phone:850-274-3927
Mailing Address - Fax:
Practice Address - Street 1:195 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:FL
Practice Address - Zip Code:32333-6349
Practice Address - Country:US
Practice Address - Phone:850-274-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide