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Individual

PATRICK L JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1161 HOWARDS CREEK MILL RD, VALE, NC 28168-6711
(704) 276-3629
Mailing address
1161 HOWARDS CREEK MILL RD, VALE, NC 28168-6711
(704) 276-3629

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
169237
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8052236
NC
Enumeration date
05/16/2006
Last updated
07/08/2007
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