Individual
JALYN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
4004 82ND ST STE G, LUBBOCK, TX 79423-2065
(806) 792-1050
(806) 795-1965
Mailing address
5219 CITY BANK PKWY STE 35, LUBBOCK, TX 79407-3545
(806) 761-0333
(806) 785-7685
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP108953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149472601
—
TX
Enumeration date
04/25/2006
Last updated
09/28/2021
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