Provider Demographics
NPI:1588494256
Name:WALKER, SHERYL SMITH
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:SMITH
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 1:9345 NW J J MEALY LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32430-2119
Mailing Address - Country:US
Mailing Address - Phone:850-447-3835
Mailing Address - Fax:
Practice Address - Street 1:2250 S FERDON BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-8457
Practice Address - Country:US
Practice Address - Phone:850-682-5635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist