Individual
DR. JESSICA ANN WALLENMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2109 N KELLY AVE, EDMOND, OK 73003-3908
(405) 513-8880
Mailing address
2109 N KELLY AVE, EDMOND, OK 73003-3908
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31309
OK
208000000X
Pediatrics Physician
P6106
TX
Other
Enumeration date
04/14/2011
Last updated
08/24/2015
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