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Individual

JASMINE T KENCY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23788
MS
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
T-2474
MS
208000000X
Pediatrics Physician
23788
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02581273
MS
01
P01696337
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/05/2011
Last updated
10/18/2016
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