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Individual

CHARLES JENKINS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
4390 GOVERNORS DRIVE, SUITE 409, FOREST PARK, GA 30297-6101
(404) 366-3647
(404) 366-3648
Mailing address
4930 GOVERNORS DR, SUITE 409, FOREST PARK, GA 30297-6101
(404) 366-3647
(404) 366-3648

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN143268NP
GA

Other

Enumeration date
04/19/2010
Last updated
09/29/2011
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