Individual
JEREMY WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-4000
Mailing address
2813 S ISEMINGER ST, PHILADELPHIA, PA 19148-4932
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP021097
PA
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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