Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1144639154 |
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| LBN Legal business name | AMY JENKINS LLC | ||||
| Authorized official | AMY JENKINS - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 08/05/2014 | ||||
| Last updated | 07/24/2024 - More than a year ago | ||||
| Identifiers |
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