Individual
JENNIFER WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4201 SPRINGHURST BLVD STE 102, LOUISVILLE, KY 40241-6156
(025) 156-0905
(502) 883-0016
Mailing address
4201 SPRINGHURST BLVD STE 102, LOUISVILLE, KY 40241-6156
(025) 156-0905
(502) 883-0016
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA866
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95004818
—
KY
Enumeration date
12/14/2005
Last updated
08/19/2025
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