Individual
GRETCHEN HEIDI JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
128 N RANDOLPH ST, GARRETT, IN 46738-1138
(260) 235-7655
(260) 357-0373
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003049A
IN
367A00000X
Advanced Practice Midwife
090000144A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200946580
—
IN
Enumeration date
09/18/2008
Last updated
10/20/2022
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