Basic Information
| Provider Information | |||||||||
| NPI: | 1225782964 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | T'YANNA | ||||||||
| MiddleName: | JOCELYNN ALEXANDRIAA | ||||||||
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| Credential: | BSN, RNFA, CNOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 770 NORTHPOINT PKWY STE 102 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334071901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616553331 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1447 MEDICAL PARK BLVD STE 300 | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334143183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617905990 | ||||||||
| FaxNumber: | 5617905952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2022 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 9596083 | FL | N | Nursing Service Providers | Registered Nurse | 163WR0006X | 9596083 | FL | Y | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.