Provider Demographics
NPI:1104415850
Name:WALKER, JUANA CARINA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:CARINA
Last Name:WALKER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CHISELHURST WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5563
Mailing Address - Country:US
Mailing Address - Phone:936-591-5030
Mailing Address - Fax:
Practice Address - Street 1:205 CHISELHURST WAY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5563
Practice Address - Country:US
Practice Address - Phone:936-591-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC264258163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health