Provider Demographics
NPI:1033869623
Name:WALKER, ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 E CLARK AVE STE I
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5171
Mailing Address - Country:US
Mailing Address - Phone:267-828-4817
Mailing Address - Fax:805-556-4889
Practice Address - Street 1:1145 E CLARK AVE STE I
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5171
Practice Address - Country:US
Practice Address - Phone:267-828-4817
Practice Address - Fax:805-556-4889
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95103901163WA2000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator