Basic Information
| Provider Information | |||||||||
| NPI: | 1891937702 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | JOANN | ||||||||
| MiddleName: | VANTA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1811 S ALMA SCHOOL RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852103001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808317566 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2770 E VAN BUREN ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850086088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022739999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2009 | ||||||||
| LastUpdateDate: | 03/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN045497 | AZ | Y | Nursing Service Providers | Registered Nurse |
No ID Information.