Individual
LATASHA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1502 MARY KAY BLVD, BENTON, AR 72015-7201
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R097931
AR
Other
Enumeration date
04/04/2016
Last updated
09/28/2018
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