Provider Demographics
NPI:1366997736
Name:AFRICA MEISHA WALKER, LLC
Entity type:Organization
Organization Name:AFRICA MEISHA WALKER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:AFRICA
Authorized Official - Middle Name:MEISHA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-521-1133
Mailing Address - Street 1:3018 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-9051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5310 OLD COURT RD STE 204
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-6201
Practice Address - Country:US
Practice Address - Phone:410-521-1133
Practice Address - Fax:410-734-2133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR192249363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty