Individual
DEIDREE NICHOLE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
904 EVERGREEN LN, DOUGLAS, GA 31533-1801
(678) 584-3999
Mailing address
PO BOX 104, DOUGLAS, GA 31534-0104
(678) 584-3999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NCO-000003
GA
363LF0000X
Family Nurse Practitioner
Primary
RN276896
GA
Other
Enumeration date
08/03/2022
Last updated
03/15/2023
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