Individual
ANGEL L JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 HAIL KNOB RD, SOMERSET, KY 42503-3434
(606) 678-9617
(606) 678-9619
Mailing address
75 HAIL KNOB RD, SOMERSET, KY 42503-3434
(606) 678-9617
(606) 678-9619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100066980
—
KY
Enumeration date
06/19/2008
Last updated
04/16/2013
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