Individual
DEBORAH CAROL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
Mailing address
PO BOX 8004, WISE, VA 24293-8004
(276) 220-3097
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0017145419
VA
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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