Provider Demographics
NPI:1285478271
Name:WALKER, TORI ROBIN
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:ROBIN
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:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25818-0666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:152 MAPLE LANE
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:WV
Practice Address - Zip Code:25818
Practice Address - Country:US
Practice Address - Phone:304-362-3639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide