Provider Demographics
NPI:1588956999
Name:WALKER, ARDITH JESSIE (RN)
Entity type:Individual
Prefix:MISS
First Name:ARDITH
Middle Name:JESSIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:ARDITH
Other - Middle Name:JESSIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:200 W. HOSPITAL DR.
Mailing Address - Street 2:
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941-1267
Mailing Address - Country:US
Mailing Address - Phone:928-338-4911
Mailing Address - Fax:928-338-1395
Practice Address - Street 1:200 W. HOSPITAL DR.
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941-1267
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:928-338-1395
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN164444163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse