Individual
DR. JACQUELINE M JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1160 W MICHIGAN ST STE 100, INDIANAPOLIS, IN 46202-5209
(317) 278-1470
Mailing address
PO BOX 7079, INDIANAPOLIS, IN 46207-7079
(317) 278-1470
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1490
TN
152W00000X
Optometrist
Primary
18003487
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1490
OD
TN
05
—
200881460
—
IN
05
—
3598926
—
TN
Enumeration date
08/24/2005
Last updated
01/12/2026
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