Elizabeth Walkley

Individual provider Active NPI Licensed Practical Nurse · Wayland, NY

NPI 1891985651 · NPPES record last updated Jul 27, 2007

Key facts

NPI
1891985651
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
164827-1 (NY)
Practice address
405 2ND Ave
Wayland, NY 14572-1023
Phone
(585) 728-2838
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
164827-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 164827-1 NY Yes

Addresses

Primary practice location

405 2ND Ave
Wayland, NY 14572-1023

Mailing address

405 2ND Ave
Wayland, NY 14572-1023
Phone (585) 728-2838

Other identifiers

IdentifierTypeStateIssuer
01660062MedicaidNY

Other providers in Wayland, NY

All providers in Wayland, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.