Individual
MRS. TASHAKA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
827 MAIN ST, GREENVILLE, MS 38701-4110
(662) 537-3065
Mailing address
1148 LOURDES ST, GREENVILLE, MS 38703-6529
(662) 822-8865
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
01/30/2018
Last updated
03/17/2018
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