Individual
MR. CHARLES RAY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN.292449
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-12217
OH
Other
Enumeration date
06/21/2011
Last updated
01/14/2020
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