Provider Demographics
NPI:1588784557
Name:WALKER, AJOKE OLOHIMA (BA ,CNA)
Entity type:Individual
Prefix:MS
First Name:AJOKE
Middle Name:OLOHIMA
Last Name:WALKER
Suffix:
Gender:F
Credentials:BA ,CNA
Other - Prefix:MRS
Other - First Name:AJOKE
Other - Middle Name:OLOHIMA
Other - Last Name:KOLAWOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 142764
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-2764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1735 MINERVA WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1490
Practice Address - Country:US
Practice Address - Phone:907-334-6468
Practice Address - Fax:907-334-6468
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100466310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRL9767OtherMCI
830439280OtherTAX ID (IRS)