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NPI Code Detail

MEDICARE: MS. JENNIFER DAWN WALKER PA-C

MEDICARE: MS. JENNIFER DAWN WALKER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant933TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14069116OTHERTNBCBS OF TENNESSEE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528094471
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER DAWN WALKER PA-C
Provider Business Mailing Address
First Line : PO BOX 634760
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2200 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3874
Country : US
Telephone Number : 423-599-9347
Fax Number : 866-369-7656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 03/26/2024

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