Individual
MRS. ELISA R JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1120 15TH STREET AUGUSTA UNIVERSITY, AUGUSTA, GA 30912-0001
(706) 721-2688
Mailing address
1120 15TH STREET AUGUSTA UNIVERSITY, AUGUSTA, GA 30912-0001
(706) 721-2688
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
CNM05484
GA
367A00000X
Advanced Practice Midwife
Primary
RN214715
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CNM05484
—
GA
Enumeration date
06/02/2019
Last updated
06/20/2019
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