Individual
ARTISHA JENEAL WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18039 NEFF RD, CLEVELAND, OH 44119-2663
(216) 224-2246
Mailing address
18039 NEFF RD, CLEVELAND, OH 44119-2663
(216) 224-2246
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401640830514
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0143457
INDEPENDENT PROVIDER NUMBER
OH
Enumeration date
06/06/2019
Last updated
06/06/2019
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