Provider Demographics
NPI:1932887551
Name:WALTON, MICHELLE LEJEUNE (APRN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LEJEUNE
Last Name:WALTON
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 1:2479 HALPERNS WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5619
Mailing Address - Country:US
Mailing Address - Phone:904-200-5324
Mailing Address - Fax:
Practice Address - Street 1:2479 HALPERNS WAY
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5619
Practice Address - Country:US
Practice Address - Phone:904-200-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine