Individual
HEATHER WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Contact information
Practice address
5301 E HEISLEY RD, MENTOR, OH 44060-1743
(440) 392-9550
(440) 392-9550
Mailing address
PO BOX 74736, CLEVELAND, OH 44194-4194
(216) 472-2730
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.273683-COA1
OH
363L00000X
Nurse Practitioner
Primary
COA.15712-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100939
—
OH
Enumeration date
03/21/2014
Last updated
05/15/2014
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