Provider Demographics
NPI:1578319919
Name:WALKER, RACHEAL SINMISOLA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:SINMISOLA
Last Name:WALKER
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 VARNUM ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-2132
Mailing Address - Country:US
Mailing Address - Phone:978-809-8006
Mailing Address - Fax:
Practice Address - Street 1:41 VARNUM ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-2132
Practice Address - Country:US
Practice Address - Phone:978-809-8006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2359835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse