1588784557 NPI number — MS. AJOKE OLOHIMA WALKER B.A ,C.N.A

Table of content: MS. AJOKE OLOHIMA WALKER B.A ,C.N.A (NPI 1588784557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588784557 NPI number — MS. AJOKE OLOHIMA WALKER B.A ,C.N.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
AJOKE
Provider Middle Name:
OLOHIMA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
B.A ,C.N.A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KOLAWOLE
Provider Other First Name:
AJOKE
Provider Other Middle Name:
OLOHIMA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588784557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 142764
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99514-2764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1735 MINERVA WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99515-1490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-334-6468
Provider Business Practice Location Address Fax Number:
907-334-6468
Provider Enumeration Date:
03/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  100466 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RL9767 . This is a "MCI" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".
  • Identifier: 830439280 . This is a "TAX ID (IRS)" identifier . This identifiers is of the category "OTHER".




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