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NPI Code Detail

MEDICARE: JENNIFER LEE WALTER NP

MEDICARE: JENNIFER LEE WALTER NP
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
1363L00000XNurse Practitioner53-76944-021KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851770523
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LEE WALTER NP
Provider Business Mailing Address
First Line : PO BOX 256
Second Line :
City : SALINA
State : KS
Zip : 67402-0256
Country : US
Telephone Number : 785-823-0633
Fax Number : 303-764-6640
Provider Business Practice Location Address
First Line : 410 E SPRUCE ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-5659
Country : US
Telephone Number : 620-272-2579
Fax Number : 620-272-2685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2015
Last Update Date : 01/12/2021

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