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General NPI Number Information
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NPI Number | 1063803625
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Entity Type | Individual
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Provider Name | JESSICA WALSH MSN, APRN, CNM
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Gender | Female
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 340 NW 5TH ST
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City | REDMOND
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State | OR
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Zip | 97756-1869
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Country | US
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Telephone | 541-526-6635
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Fax | 541-526-6636
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Provider Business Mailing Address
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Address Line | PO BOX 6095
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City | BEND
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State | OR
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Zip | 97708-6095
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Country | US
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Telephone | 541-706-5922
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Fax | 541-706-6869
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2025032440
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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