Healthcare Provider Details

I. General information

NPI: 1609231679
Provider Name (Legal Business Name): JESSICA BARTON WALKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N JAMES CAMPBELL BLVD SUITE 200
COLUMBIA TN
38401-2754
US

IV. Provider business mailing address

2000 CALLAWAY PARK PL
THOMPSONS STATION TN
37179-5406
US

V. Phone/Fax

Practice location:
  • Phone: 931-381-2663
  • Fax: 931-490-1369
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2889
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: