Provider Demographics
NPI:1306458237
Name:WALKER, ROSANNA (DNP)
Entity type:Individual
Prefix:
First Name:ROSANNA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4031
Mailing Address - Country:US
Mailing Address - Phone:864-227-9393
Mailing Address - Fax:864-227-9377
Practice Address - Street 1:408 W ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4031
Practice Address - Country:US
Practice Address - Phone:864-227-9393
Practice Address - Fax:864-227-9377
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC24221OtherLICENSE NURSING BOARD - SC
SC77728OtherLICENSE NURSING BOARD - SC