Individual
JESSICA LYNN WALLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
328 MAIN ST NE, LOS LUNAS, NM 87031-7454
(505) 916-5446
Mailing address
328 MAIN ST NE, LOS LUNAS, NM 87031-7454
(505) 916-5446
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
70462
NM
Other
Enumeration date
11/02/2022
Last updated
01/15/2024
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