Individual
KAITLYN CARSON JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 CLUB RD STE 160, EUGENE, OR 97401-2439
(541) 345-1722
(541) 485-7049
Mailing address
PO BOX 70779, SPRINGFIELD, OR 97475-0137
(541) 345-1722
(541) 485-7049
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
201801209
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10049495
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16564897
CAQH
—
05
—
500864124
—
OR
05
—
500864379
—
OR
Enumeration date
08/21/2025
Last updated
12/09/2025
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