Healthcare Provider Details

I. General information

NPI: 1437801651
Provider Name (Legal Business Name): JENNIFER WALKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 S EASTERN AVE STE 407
HENDERSON NV
89052-3908
US

IV. Provider business mailing address

452 WINTHROP PL
HENDERSON NV
89074-5746
US

V. Phone/Fax

Practice location:
  • Phone: 702-909-7170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number847230
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: