Provider Demographics
NPI:1538297460
Name:WALKER, JAYME LEKE (NP-C)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:LEKE
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176C W UNIVERSITY PKWY # C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1616
Mailing Address - Country:US
Mailing Address - Phone:731-660-6915
Mailing Address - Fax:731-668-4557
Practice Address - Street 1:176C W UNIVERSITY PKWY # C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1616
Practice Address - Country:US
Practice Address - Phone:731-660-6915
Practice Address - Fax:731-668-4557
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 12550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN 137680OtherSTATE LICENSE
TN3644933Medicaid
TNAPN 12550OtherSTATE LICENSE
TN3644933Medicare PIN
TNRN 137680OtherSTATE LICENSE