Individual
KACY R JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3643 N ROXBORO ST, DURHAM, NC 27704-2702
(919) 470-6185
Mailing address
PO BOX 15609, DURHAM, NC 27704-0609
(919) 384-0700
(919) 384-0600
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
219404
NC
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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