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Individual

MR. HERMAN JENKINS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6000 W HIGHWAY 98, PENSACOLA, FL 32512-0001
(850) 505-6762
Mailing address
508 PHEASANT TRL, CRESTVIEW, FL 32536-5475
(360) 649-5706

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
681113
CA
367500000X
Certified Registered Nurse Anesthetist
77866
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
9277167
FL

Other

Enumeration date
02/01/2007
Last updated
03/09/2016
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