Individual
BRENDA MOODY WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN,CFNP
Contact information
Practice address
4407 MACCORKLE AVE SE, CHARLESTON, WV 25304-2541
(304) 925-0392
(304) 825-0392
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18804
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0167011000
—
WV
Enumeration date
04/12/2006
Last updated
11/12/2020
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