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NPI Code Detail

MEDICARE: MRS. JEANNIE EVETTE MASON-WALKER FNP-C

MEDICARE: MRS. JEANNIE EVETTE MASON-WALKER FNP-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
1363LF0000XFamily Nurse Practitioner0024178781VA

General Provider Information

NPI Number : 1861023046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEANNIE EVETTE MASON-WALKER FNP-C
Provider Business Mailing Address
First Line : 8711 BEACH RD
Second Line :
City : CHESTERFIELD
State : VA
Zip : 23838-5355
Country : US
Telephone Number : 804-386-3277
Fax Number :
Provider Business Practice Location Address
First Line : 2421 CHAMBERLAYNE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23222-4205
Country : US
Telephone Number : 804-329-8510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2020
Last Update Date : 04/07/2021

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