Provider Demographics
NPI:1376262238
Name:WALKER, JINKY JIREH LOMONGO (PMHNP)
Entity type:Individual
Prefix:
First Name:JINKY JIREH
Middle Name:LOMONGO
Last Name:WALKER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 SONG BIRD LAKES DR
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-9314
Mailing Address - Country:US
Mailing Address - Phone:904-508-4999
Mailing Address - Fax:
Practice Address - Street 1:3509 SONG BIRD LAKES DR
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-9314
Practice Address - Country:US
Practice Address - Phone:904-508-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11044229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8411Other8411