Walls, Jennifer Lynn

Walls, Jennifer Lynn is an individual health care provider with primary practice located at 9981 S Healthpark Dr , Fort Myers FL 33908-3618. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Walls, Jennifer Lynn can be contacted via phone (239) 343-6260.

Contact Information

Primary practice address
9981 S Healthpark Dr Fort Myers FL 33908-3618
Phone: (239) 343-6260
Fax: (239) 343-6259
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X DR.0056229 Colorado
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E-11128 Arkansas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29629 Oklahoma
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X ME141875 Florida

Profile Details

NPI number 1104138890
LBN Legal business name Walls, Jennifer Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2010
Last updated Mar 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104138890 NPPES
Florida MEDICAID 103693300
Florida MEDICAID 224991001

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