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Individual

DANA JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
300 W HOSPITAL RD, CONNELLY HEALTH CLINIC, FORT GORDON, GA 30905-5741
(706) 787-5161
Mailing address
300 W HOSPITAL RD, CONNELLY HEALTH CLINIC, FORT GORDON, GA 30905-5741
(706) 787-5161

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN117622
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000871406A
GA
05
000871406B
GA
05
NPO386
SC
Enumeration date
05/26/2006
Last updated
10/08/2013
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