Individual
MR. KELLEY RAY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-FNP
Contact information
Practice address
960 E WALNUT LAWN, SUITE 201, SPRINGFIELD, MO 65807
(417) 269-4450
(417) 269-8333
Mailing address
960 E WALNUT LAWN, SUITE 201, SPRINGFIELD, MO 65807
(417) 269-4450
(417) 269-8333
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2006023820
MO
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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