Individual
LISA W JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
912 SETON DR, CUMBERLAND, MD 21502-1818
(301) 722-3111
(301) 722-5135
Mailing address
912 SETON DR, CUMBERLAND, MD 21502-1818
(301) 722-3111
(301) 722-5135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R084836
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0224253
CIGNA
MD
05
—
1538463666
—
WV
05
—
552235800
—
MD
05
—
552235801
—
MD
01
—
973435-02
BCBS POS
MD
01
—
W399 0013
BCBS FEDERAL
MD
Enumeration date
01/04/2011
Last updated
02/10/2025
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