MEDICARE: VARLINA IMAN 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	363LF0000X	Family Nurse Practitioner	1085601	TX

General Provider Information

NPI Number	:	1962133678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VARLINA IMAN JENKINS

Provider Business Mailing Address
First Line	:	1500 N HASKELL AVE APT 2010
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-5221
Country	:	US
Telephone Number	:	903-749-3483
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 N HASKELL
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-5221
Country	:	US
Telephone Number	:	214-820-3406
Fax Number	:

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

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	06/16/2023

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Directions to “ VARLINA IMAN JENKINS ” Practice Location

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