Healthcare Provider Details

I. General information

NPI: 1245581149
Provider Name (Legal Business Name): ARLENE WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2.5 MILES N HWY 191 MP 463
MANY FARMS AZ
86538
US

IV. Provider business mailing address

P.O. BOX 706
MANY FRMS AZ
86538
US

V. Phone/Fax

Practice location:
  • Phone: 928-781-3195
  • Fax: 382-781-3196
Mailing address:
  • Phone: 928-781-3195
  • Fax: 928-781-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number673845
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: