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NPI Code Detail

MEDICARE: JENNIFER JEANNE WINTERS WALKER CNP

MEDICARE: JENNIFER JEANNE WINTERS WALKER CNP
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
1363LF0000XFamily Nurse Practitioner60225NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F05200236OTHERAMERICAN ASSOCIATION OF NURSE PRACTITIONERS CERTIFICATION BOARD
260225OTHERNMNEW MEXICO BOARD OF NURSING

General Provider Information

NPI Number : 1760006225
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JEANNE WINTERS WALKER CNP
Provider Business Mailing Address
First Line : 7801 ACADEMY RD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-3379
Country : US
Telephone Number : 505-272-2700
Fax Number : 505-272-2760
Provider Business Practice Location Address
First Line : 1901 JUAN TABO BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-3303
Country : US
Telephone Number : 505-407-2163
Fax Number : 505-407-2125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2020
Last Update Date : 04/24/2024

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