Individual provider · Type 1 NPI

Charles Walker

Licensed Practical Nurse · Philadelphia, PA

NPI number 1104782309 Active

Practice location

111 N 49th St
Philadelphia, PA 19139-2718

Call (215) 471-2866 Map

Fax (215) 471-2866

Mailing address

8241 Provident St
Philadelphia, PA 19150-1706

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XPN081780L (PA)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1104782309

Charles Walker's National Provider Identifier is 1104782309, issued on Dec 31, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Philadelphia, PA. The record was last updated on Dec 31, 2025.