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Individual

MARLENE E WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 504-3789
(703) 295-9369
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747-2354
(516) 945-3000
(516) 945-3131

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0024073729
VA
367500000X
Certified Registered Nurse Anesthetist
0024073729
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639161805
VA
05
MEDICAID
MD
Enumeration date
08/16/2005
Last updated
03/30/2015
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