Individual
EBONY SHAYTEVA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
(803) 939-4561
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2203
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28880
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2024
Last updated
05/11/2026
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