Individual
DR. STACY ANN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5220 HIGHLAND RD, SUITE 230, WATERFORD, MI 48327-1913
(248) 618-9400
(248) 618-9490
Mailing address
5220 HIGHLAND RD, SUITE 230, WATERFORD, MI 48327-1913
(248) 618-9400
(248) 618-9490
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301059217
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4493396
—
MI
Enumeration date
08/23/2006
Last updated
12/11/2007
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