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General NPI Number Information
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NPI Number | 1952633224
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Entity Type | Individual
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Provider Name | JENNIFER ROSE WALSH PMHNP-BC, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 180 S BROADWAY STE 207
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1845
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Country | US
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Telephone | 914-574-4535
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Fax | 914-574-4535
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Provider Business Mailing Address
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Address Line | 180 S BROADWAY STE 207
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1845
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Country | US
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Telephone | 914-574-4535
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Fax | 914-574-4535
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F420952-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ00334400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 404582
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License Number State | NY
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