Individual
JENNELLE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
117 N. MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-4187
(315) 370-3115
Mailing address
117 N. MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-4187
(315) 370-3115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
NY
363AM0700X
Medical Physician Assistant
Primary
033898
NY
Other
Enumeration date
06/11/2025
Last updated
08/13/2025
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