Provider Demographics
NPI:1740707827
Name:WALKER, JAIME MICHELE (MSN, RN, MLDE, CDE)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:MICHELE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSN, RN, MLDE, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 TIMOTHY WAY
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-9123
Mailing Address - Country:US
Mailing Address - Phone:502-592-8842
Mailing Address - Fax:502-629-6744
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1115927163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator