Provider Demographics
NPI:1700165727
Name:WALKER WEATHERSPOON, SHNEA NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHNEA
Middle Name:NICOLE
Last Name:WALKER WEATHERSPOON
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 1:4606 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1342
Mailing Address - Country:US
Mailing Address - Phone:216-297-5491
Mailing Address - Fax:216-938-9199
Practice Address - Street 1:4606 E 93RD ST
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1342
Practice Address - Country:US
Practice Address - Phone:216-297-5491
Practice Address - Fax:216-938-9199
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN360558163WC0400X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WC0400XNursing Service ProvidersRegistered NurseCase Management