Healthcare Provider Details

I. General information

NPI: 1396991071
Provider Name (Legal Business Name): JAIME L WALKER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME L WALKER HAMPSHIRE AU.D.

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 W STADIUM BLVD
JEFFERSON CITY MO
65109-6023
US

IV. Provider business mailing address

PO BOX 104240
JEFFERSON CITY MO
65110-4240
US

V. Phone/Fax

Practice location:
  • Phone: 573-556-7708
  • Fax: 573-893-8061
Mailing address:
  • Phone: 573-556-5771
  • Fax: 573-636-9756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2007027352
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: