Provider Demographics
NPI:1063229060
Name:WALKER, TERRION RASHAAD
Entity type:Individual
Prefix:
First Name:TERRION RASHAAD
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 SPRING MOUNTAIN RD STE 52
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8620
Mailing Address - Country:US
Mailing Address - Phone:725-204-8351
Mailing Address - Fax:
Practice Address - Street 1:5201 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3633
Practice Address - Country:US
Practice Address - Phone:702-513-5269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant