Individual
TARA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
2619 N 123RD ST, KANSAS CITY, KS 66109-3312
(913) 909-3013
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
116082
KS
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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