Provider Demographics
NPI:1508978206
Name:DAVIS WALKER, ELIZABETH ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:DAVIS WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 LEE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3413
Mailing Address - Country:US
Mailing Address - Phone:216-417-3250
Mailing Address - Fax:216-417-3251
Practice Address - Street 1:2323 LEE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3413
Practice Address - Country:US
Practice Address - Phone:216-417-3250
Practice Address - Fax:216-417-3251
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0355510-21363LA2200X
OH035551021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2680317Medicaid
OHH499810Medicare PIN