Provider Demographics
NPI:1073728689
Name:WALKER-BROWN, DONNA M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:WALKER-BROWN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18111 OLYMPIA RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1023
Mailing Address - Country:US
Mailing Address - Phone:216-486-8801
Mailing Address - Fax:
Practice Address - Street 1:18111 OLYMPIA RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1023
Practice Address - Country:US
Practice Address - Phone:216-486-8801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.088805164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2239901Medicaid