Provider Demographics
NPI:1427919240
Name:WALLING, JENN (RN)
Entity type:Individual
Prefix:
First Name:JENN
Middle Name:
Last Name:WALLING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 NW 37TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-6311
Mailing Address - Country:US
Mailing Address - Phone:360-957-6733
Mailing Address - Fax:360-957-6733
Practice Address - Street 1:722 NW 37TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-6311
Practice Address - Country:US
Practice Address - Phone:360-957-6733
Practice Address - Fax:360-957-6733
Is Sole Proprietor?:No
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9630243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse