Individual
HEATHER M JENKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
40 MCINTYRE ST APT C2, FORT EDWARD, NY 12828-1644
(518) 630-1298
Mailing address
40 MCINTYRE ST APT C2, FORT EDWARD, NY 12828-1644
(518) 630-1298
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
343409570513E
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H41731474
—
NY
Enumeration date
12/20/2019
Last updated
12/20/2019
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