Healthcare Provider Details

I. General information

NPI: 1437411097
Provider Name (Legal Business Name): JENNIFER D. WALKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER PEARL DARDEN FNP

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 JUNGLE RD
EDISTO ISLAND SC
29438-3005
US

IV. Provider business mailing address

134 JUNGLE RD
EDISTO ISLAND SC
29438-3005
US

V. Phone/Fax

Practice location:
  • Phone: 843-897-7757
  • Fax:
Mailing address:
  • Phone: 843-897-7757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17830
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: