MEDICARE: SHARON JENKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)	765705	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8889782	OTHER	GA	NPN NATIONAL PRODUCER NUMBER

General Provider Information

NPI Number	:	1841627551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON JENKINS

Provider Business Mailing Address
First Line	:	PO BOX 150057
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-0180
Country	:	US
Telephone Number	:	404-397-2228
Fax Number	:	404-622-8887

Provider Business Practice Location Address
First Line	:	405 GRANT PARK PL SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-1429
Country	:	US
Telephone Number	:	404-397-2228
Fax Number	:	404-622-8887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2013
Last Update Date	:	09/27/2013

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Directions to “ SHARON JENKINS ” Practice Location

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