Individual
DEBRA LEE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
100 PARK ST, HONESDALE, PA 18431-2023
(570) 290-8780
Mailing address
100 PARK ST, HONESDALE, PA 18431-2023
(570) 290-8780
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
SP033570
PA
363L00000X
Nurse Practitioner
Primary
0024175274
VA
Other
Enumeration date
08/11/2017
Last updated
03/09/2026
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