Provider Demographics
NPI:1164687158
Name:WALTON, MARION RUTH (RN, MS)
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:RUTH
Last Name:WALTON
Suffix:
Gender:F
Credentials:RN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 SOMERSET LN S
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-3247
Mailing Address - Country:US
Mailing Address - Phone:414-282-7222
Mailing Address - Fax:
Practice Address - Street 1:5406 SOMERSET LN S
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-3247
Practice Address - Country:US
Practice Address - Phone:414-282-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2008-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI033607163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse