Individual
PATRICK M JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-2000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
504989
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046912
RE-CERT #
—
05
—
100784570A
—
OK
01
—
86117U
BCBS PROV #
TX
Enumeration date
03/03/2006
Last updated
05/05/2021
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