Individual
ELIZABETH CLUNEY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 662-0339
(502) 852-3762
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28245791C
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
3018044
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018125
—
IN
05
—
7100562730
—
KY
Enumeration date
12/07/2015
Last updated
05/22/2023
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