Provider Demographics
NPI:1386096485
Name:WALKER, TERYN J'NAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TERYN
Middle Name:J'NAE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TERYN
Other - Middle Name:
Other - Last Name:BIBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:808 JOLIET AVE UNIT 120
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79415-1148
Mailing Address - Country:US
Mailing Address - Phone:806-761-0738
Mailing Address - Fax:
Practice Address - Street 1:808 JOLIET AVE UNIT 120
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-1148
Practice Address - Country:US
Practice Address - Phone:806-761-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX590411835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care