Individual provider · Type 1 NPI
Jennifer Douglas, RN00123804
Psychiatric/Mental Health Nurse Practitioner · Walla Walla, WA
NPI number
1235476706
Active
Practice location
1520 Kelly Pl Ste 220
Walla Walla, WA 99362-8607
Mailing address
PO Box 1595, 1520 Kelly Place, Suite 220
Walla Walla, WA 99362-0329
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse | 163WA2000X | RN00123804 (WA) |
| School Registered Nurse | 163WS0200X | RN00123804 (WA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP60427024 (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1235476706
Jennifer Douglas, RN00123804's National Provider Identifier is 1235476706, issued on Jan 3, 2013. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Walla Walla, WA. The record was last updated on Jan 15, 2014.