Individual
ROYEISHA DESHAWN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3635 HANCOCK ST, JACKSON, MS 39213-5803
(323) 910-7641
Mailing address
3635 HANCOCK ST, JACKSON, MS 39213-5803
(323) 910-7641
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800890072
DRIVERS LICENSE
MS
Enumeration date
08/17/2020
Last updated
08/17/2020
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