Provider Demographics
NPI:1316733504
Name:WALKER-MATHURIN, KATHLEEN
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:WALKER-MATHURIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MAYO ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2573
Mailing Address - Country:US
Mailing Address - Phone:919-910-2001
Mailing Address - Fax:
Practice Address - Street 1:129 MAYO ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2573
Practice Address - Country:US
Practice Address - Phone:919-910-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84251164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse