Healthcare Provider Details

I. General information

NPI: 1710706601
Provider Name (Legal Business Name): MRS. NEKASHIA R JENKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 622
BRYANT AR
72089-0622
US

IV. Provider business mailing address

400 S MAIN ST STE 100
SEARCY AR
72143-7801
US

V. Phone/Fax

Practice location:
  • Phone: 501-410-0785
  • Fax:
Mailing address:
  • Phone: 501-279-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF04240394
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: