Individual
VALERIE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 RIVIERA LN, RIVERDALE, GA 30296-1380
(678) 973-9047
Mailing address
9 RIVIERA LN, RIVERDALE, GA 30296-1380
(678) 973-9047
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LPN064005
GA
Other
Enumeration date
06/25/2016
Last updated
06/25/2016
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