Individual
JORDAN LEVI WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
16990 W 86TH ST, STE 100, LENEXA, KS 66219-3211
(913) 676-8400
(913) 599-1692
Mailing address
16990 W 86TH ST, STE 100, LENEXA, KS 66219-3211
(913) 676-8400
(913) 599-1692
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02244
KS
363AS0400X
Surgical Physician Assistant
15-02244
KS
Other
Enumeration date
05/29/2019
Last updated
12/30/2025
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