Individual
RANDON CARL JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4669 E 8 MILE RD, WARREN, MI 48091-2709
(313) 416-6262
Mailing address
6547 WINDMILL LN, WEST BLOOMFIELD, MI 48324-3759
(313) 516-7690
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704273274
MI
Other
Enumeration date
03/03/2018
Last updated
03/03/2018
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