Individual
LATRELL JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.A.
Contact information
Practice address
208 CURTIS ST, SYLVANIA, GA 30467-2432
(912) 978-8282
Mailing address
208 CURTIS ST, SYLVANIA, GA 30467-2432
(912) 978-8282
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
47-2636910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-263-6910
—
GA
Enumeration date
03/23/2015
Last updated
03/27/2015
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