Healthcare Provider Details

I. General information

NPI: 1992449268
Provider Name (Legal Business Name): JASMINE N WALKER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2022
Last Update Date: 10/17/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 JEFFERSON AVE
MEMPHIS TN
38103-2807
US

IV. Provider business mailing address

UTHSC COLLEGE OF NURSING 874 UNION AVENUE RM 325
MEMPHIS TN
38163-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-515-3500
  • Fax: 901-515-3509
Mailing address:
  • Phone: 901-448-6128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number232088
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number37103
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: