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Jechell Lary-Waller, PMHNP — NPI 1295548378, Gray, GA | NPI Central

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NPI 1295548378

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Jechell Lary-Waller, PMHNP

NPI 1295548378 · Psychiatric/Mental Health Nurse Practitioner · Gray, GA

Provider details

NPI number: 1295548378
Entity type: Individual
Primary specialty: Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Credential: PMHNP
Sex: Female
Sole proprietor: Yes
License: RN15699 (GA)

Specialties & taxonomies

Psychiatric/Mental Health Nurse PractitionerPrimary363LP0808XLicense RN15699 (GA)
Physician Assistants & Advanced Practice Nursing Providers

Practice location

452 Graham Woods Cir

Gray, GA 31032-4914

Phone: (478) 390-3836

Approximate (ZIP-level) locationGet directions

More GA providers

Mailing address

452 Graham Woods Cir

Gray, GA 31032-4914

Additional practice locations (1)

4539 N 22nd St Ste R
Phoenix, AZ 85016-4639
Phone: (478) 390-3836

Registry dates

Enumerated: 2025-01-31
Last updated: 2025-07-24
Certified: 2025-07-24

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.