Provider Demographics
NPI:1306307046
Name:LYNN-WALKER, CHIQUITA KAWANDA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CHIQUITA
Middle Name:KAWANDA
Last Name:LYNN-WALKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 12TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1903
Mailing Address - Country:US
Mailing Address - Phone:727-643-2094
Mailing Address - Fax:
Practice Address - Street 1:2827 12TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1903
Practice Address - Country:US
Practice Address - Phone:727-643-2094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001898363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily