Provider Demographics
NPI:1437399409
Name:WALKUP-PIERCE, VICTORIA RUSK (AUD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RUSK
Last Name:WALKUP-PIERCE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:WALKUP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4488
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:13535 NEMOURS PKWY
Practice Address - Street 2:NEMOURS CHILDRENS HOSPITAL
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7402
Practice Address - Country:US
Practice Address - Phone:407-567-4000
Practice Address - Fax:407-650-7124
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY908231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist