Provider Demographics
NPI:1699965400
Name:WALKER, ARLENE YVETTE
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:YVETTE
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2255
Mailing Address - Country:US
Mailing Address - Phone:612-728-2081
Mailing Address - Fax:612-729-2616
Practice Address - Street 1:4123 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2255
Practice Address - Country:US
Practice Address - Phone:612-728-2081
Practice Address - Fax:612-729-2616
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program