Provider Demographics
NPI:1316430408
Name:WALKER, SANDRA RENEE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:RENEE
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 1:7300 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1010
Mailing Address - Country:US
Mailing Address - Phone:301-675-5369
Mailing Address - Fax:
Practice Address - Street 1:7300 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-1010
Practice Address - Country:US
Practice Address - Phone:301-675-5369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health