Individual
JENNA WALCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 S BRYN MAWR AVE, BRYN MAWR, PA 19010-3143
(484) 337-3000
Mailing address
4111 IDAHO AVE, NASHVILLE, TN 37209-3678
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
20795
TN
Other
Enumeration date
12/26/2015
Last updated
07/19/2018
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