Provider Demographics
NPI:1194616581
Name:WALKER, CLINTESA MONIQUE (RN)
Entity type:Individual
Prefix:
First Name:CLINTESA
Middle Name:MONIQUE
Last Name:WALKER
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 1:634 E 127TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2442
Mailing Address - Country:US
Mailing Address - Phone:216-336-1638
Mailing Address - Fax:216-336-1638
Practice Address - Street 1:5010 MAYFIELD RD STE 304
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2697
Practice Address - Country:US
Practice Address - Phone:216-284-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.467311163WC1500X, 163WP0200X, 163WP0218X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics