Provider Demographics
NPI:1396991071
Name:WALKER, JAIME L (AUD)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:WALKER HAMPSHIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 104240
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65110-4240
Mailing Address - Country:US
Mailing Address - Phone:573-556-5771
Mailing Address - Fax:573-636-9756
Practice Address - Street 1:1241 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6023
Practice Address - Country:US
Practice Address - Phone:573-556-7708
Practice Address - Fax:573-893-8061
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007027352237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCP9089OtherRAILROAD GROUP
MO1396991071Medicaid
MOP00635932OtherMEDICARE RAILROAD
MO990001391OtherGROUP MEDICARE PTAN
MO1396991071Medicaid