Provider Demographics
NPI:1346435914
Name:WALKER-HENRY, ETHEL PAULETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ETHEL
Middle Name:PAULETTE
Last Name:WALKER-HENRY
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 1:1524 TOWNSHIP CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5070
Mailing Address - Country:US
Mailing Address - Phone:919-264-0313
Mailing Address - Fax:
Practice Address - Street 1:1524 TOWNSHIP CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5070
Practice Address - Country:US
Practice Address - Phone:919-264-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135584163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care