Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN129698 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN129698 | GA |
NPI | 1023166428 |
---|---|
Provider Name | Jennifer Joiner Walker |
First Address | Columbus, GA 31904-8744 |
Second Address | Columbus, GA 31904-8744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 20/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P88695 | (02) | GA |