Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | NP95014821 | CA |
NPI | 1386259695 |
---|---|
Provider Name | Erin Jenkins |
First Address | San Diego, CA 92106-1224 |
Second Address | La Jolla, CA 92037-1300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2020 |
Last Update Date | 14/09/2020 |