Wall, Jalyn
Wall, Jalyn is an individual health care provider with primary practice located at 4004 82Nd St Ste G , Lubbock TX 79423-2065. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wall, Jalyn can be contacted via phone (806) 792-1050.Contact Information
Primary practice address
4004 82Nd St Ste G
Lubbock TX 79423-2065
Phone: (806) 792-1050
Fax: (806) 795-1965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP108953 | Texas |
Profile Details
| NPI number | 1073579454 |
|---|---|
| LBN Legal business name | Wall, Jalyn |
| Credentials | Certified Family Nurse Practitioner (CFNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Sep 28th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073579454 | NPPES |
| Texas | MEDICAID | 149472601 |
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