Provider Demographics
NPI:1437411097
Name:WALKER, JENNIFER D (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:PEARL
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:111 DOCTOR CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6502
Mailing Address - Country:US
Mailing Address - Phone:800-491-0909
Mailing Address - Fax:
Practice Address - Street 1:111 DOCTOR CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6502
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2082Medicaid
SCP01396745OtherRR MEDICARE
SCAA92685277Medicare PIN
SCAA92687126Medicare PIN
SCAA92688798Medicare PIN
SCAA92685282Medicare PIN
SCAA92686834Medicare PIN
SCAA92687499Medicare PIN
SCAA92687555Medicare PIN
SCAA92687819Medicare PIN
SCAA92685281Medicare PIN
SCP01396745OtherRR MEDICARE
SCNP2082Medicaid
SCAA92686882Medicare PIN
SCAA92687498Medicare PIN
SCAA92686868Medicare PIN
SCAA92689988Medicare PIN