Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | ME82819 | FL |
NPI | 1174540785 |
---|---|
Provider Name | Dr. Jennifer T. Jenkins |
First Address | Tulsa, OK 74136-3347 |
Second Address | Tulsa, OK 74136-1907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 11/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00124310 | (05) | MS |
009961720 | (05) | AL |
200362600 | (05) | KS |
262106100 | (05) | FL |
H06962 | (02) |