Individual
JESSICA R. WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
901 SHELBY ST, INDIANAPOLIS, IN 46203-1384
(317) 957-2070
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4782
(317) 957-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015483A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300093915
—
IN
Enumeration date
01/23/2024
Last updated
10/02/2024
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