Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 309003 | LA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2021032877 | MO |
NPI | 1760800940 |
---|---|
Provider Name | Nia J Jenkins |
First Address | Kansas City, MO 64108-2733 |
Second Address | Kansas City, MO 64108-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 28/10/2021 |