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Individual

JENNIFER LEE WALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
410 E SPRUCE ST, GARDEN CITY, KS 67846-5659
(620) 272-2579
(620) 272-2685
Mailing address
PO BOX 256, SALINA, KS 67402-0256
(785) 823-0633
(303) 764-6640

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-76944-021
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200631180A
OK
05
201123060A
KS
Enumeration date
05/27/2015
Last updated
01/12/2021
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