Provider Demographics
NPI:1053171447
Name:WALKER, JASMONIQUE (BSN, RN)
Entity type:Individual
Prefix:
First Name:JASMONIQUE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 N 25TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5222
Mailing Address - Country:US
Mailing Address - Phone:804-814-5429
Mailing Address - Fax:
Practice Address - Street 1:1121 N 25TH ST APT A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5222
Practice Address - Country:US
Practice Address - Phone:804-814-5429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001297402163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse