Provider Demographics
NPI:1568358562
Name:WALCK, JODI LYNN
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:WALCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 Y ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2275
Mailing Address - Country:US
Mailing Address - Phone:402-440-9865
Mailing Address - Fax:
Practice Address - Street 1:6955 Y ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2275
Practice Address - Country:US
Practice Address - Phone:402-440-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider