Provider Demographics
NPI:1700684339
Name:WALKER, DOMINIQUE DESHEY
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:DESHEY
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 1:2744 KANSAS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4127
Mailing Address - Country:US
Mailing Address - Phone:402-512-2326
Mailing Address - Fax:
Practice Address - Street 1:6031 VILLE DE SANTE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1136
Practice Address - Country:US
Practice Address - Phone:531-262-9481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health