Individual
REVA MARIE MACE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2007 HIGHLAND PL, VICKSBURG, MS 39180-4554
(601) 218-2796
Mailing address
2007 HIGHLAND PL, VICKSBURG, MS 39180-4554
(601) 218-2796
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
902801
MS
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
901802
MS
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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