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Individual

MR. ANDRE FENTON JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
STNA, EMT-B

Contact information

Practice address
6339 AFTON DR, DAYTON, OH 45415-1833
(937) 270-0409
Mailing address
PO BOX 516, DAYTON, OH 45404-0516
(937) 270-0409

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
0085408
OH
376K00000X
Nurse's Aide
Primary
401264800711
OH

Other

Enumeration date
10/01/2011
Last updated
10/01/2011
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