Individual
JESSICA B WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604
(423) 794-5520
(423) 282-0720
Mailing address
100 MAY APPLE LN, JOHNSON CITY, TN 37615-4386
(423) 557-4937
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15671
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523569
—
TN
Enumeration date
03/11/2011
Last updated
06/01/2023
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