Provider Demographics
NPI:1659690683
Name:WALKER, JERRI L (CNM)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-8035
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:355 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2153
Practice Address - Country:US
Practice Address - Phone:706-369-0019
Practice Address - Fax:706-369-1989
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2021-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN070784367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300034164AMedicaid