Individual
JENNIE L. WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
DAVID CROCKETT HIGH SCHOOL HEALTH CLINIC, 684 OLD STATE ROUTE 34, JONESBOROUGH, TN 37659
(423) 753-0057
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4078
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN5169
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN5169
APN LICENSE
TN
Enumeration date
10/26/2006
Last updated
03/07/2023
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