Individual
STEPHANIE ANN JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
Mailing address
PO BOX 840, OSAGE BEACH, MO 65065-0840
(573) 302-1661
(573) 302-1719
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2021021290
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021021290
STATE CRNA LICENSE
MO
Enumeration date
06/10/2021
Last updated
06/10/2021
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