Doctor profile · Federal record
Dr. Jessica Walthall, PPCNP-BC
Pediatric Nurse Practitioner · Registered Nurse · Registered Nurse · New York, NY
- NPI 1104316454
- 8 yrs on file
- Licensed in 2 states
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
2637 Broadway
New York, NY 100255022
(917) 921-6219
Credentials & registration
- NPI registered
- May 2018 — 8 yrs on file
- Profile last updated
- January 18, 2022
- Specialty taxonomy
- 363LP0200X — NUCC code
- State licenses (3)
- New York #382872 · Connecticut #137013 · New York #727527
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1104316454. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$78
Transactions
4
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| SANOFI PASTEUR INC. | 1 | $24.42 | |
| GlaxoSmithKline, LLC. | 1 | $24.07 | |
| kaleo, Inc. | 1 | $16.07 | |
| Phadia US Inc. | 1 | $13.53 |
By nature of payment
Frequently asked questions
What is Dr. Jessica Walthall's medical specialty?
Dr. Jessica Walthall practices Pediatric Nurse Practitioner in New York, NY.
Where does Dr. Jessica Walthall practice?
Dr. Jessica Walthall practices at 2637 Broadway, New York, NY 100255022. Office phone: 9179216219.
What is Dr. Jessica Walthall's NPI?
Dr. Jessica Walthall's National Provider Identifier (NPI) is 1104316454, issued by NPPES.