Provider Demographics
NPI:1053009456
Name:WALKER, ANTOINETTE TAMARA I (NURSING ASSISTANT)
Entity type:Individual
Prefix:MISS
First Name:ANTOINETTE
Middle Name:TAMARA
Last Name:WALKER
Suffix:I
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 SANFORD CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-4149
Mailing Address - Country:US
Mailing Address - Phone:941-592-0107
Mailing Address - Fax:
Practice Address - Street 1:1817 SANFORD CIR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-4149
Practice Address - Country:US
Practice Address - Phone:941-592-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care