Provider Demographics
NPI:1558180943
Name:WALKER, JESSICA MARIE (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BURKE CT
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7520
Mailing Address - Country:US
Mailing Address - Phone:606-791-3527
Mailing Address - Fax:
Practice Address - Street 1:103 BURKE CT
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7520
Practice Address - Country:US
Practice Address - Phone:606-791-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4027896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily