Individual
MRS. JENNIFER NICOLE WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
73 LONG STREET, MILLRY, AL 36558-4564
(251) 846-3233
(251) 846-3224
Mailing address
PO BOX 465, MILLRY, AL 36558-0465
(251) 846-3233
(251) 846-3224
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-092094
AL
363LF0000X
Family Nurse Practitioner
Primary
R864418
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05485262
—
MS
Enumeration date
02/17/2010
Last updated
01/31/2022
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