Individual
JEDD DOUGLAS WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
459 SPRINGWOOD LN, IDAHO FALLS, ID 83404-8108
(208) 716-5063
Mailing address
459 SPRINGWOOD LN, IDAHO FALLS, ID 83404-8108
(208) 716-5063
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
56948
ID
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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