Individual
LAURA REGINA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4340 DECATUR DR APT 5305, COLLEGE STATION, TX 77845-9723
(706) 414-6709
Mailing address
4340 DECATUR DR APT 5305, COLLEGE STATION, TX 77845-9723
(706) 414-6709
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
67592
ME
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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