Provider Demographics
NPI:1477932143
Name:WALK, ARLENE (RN)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:WALK
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 1:10014 PIERPONT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-3247
Mailing Address - Country:US
Mailing Address - Phone:313-820-6937
Mailing Address - Fax:
Practice Address - Street 1:10014 PIERPONT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-3247
Practice Address - Country:US
Practice Address - Phone:313-820-6937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH378593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse