Individual
SALLY J JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
024859-23-05
NH
363LF0000X
Family Nurse Practitioner
024859-23-03
NH
Other
Enumeration date
07/11/2006
Last updated
07/21/2020
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