Healthcare Provider Details

I. General information

NPI: 1720375058
Provider Name (Legal Business Name): CATHERINE MARY JENKINS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SW 74TH LN
OCALA FL
34476-6817
US

IV. Provider business mailing address

205 SW 74TH LN
OCALA FL
34476-6817
US

V. Phone/Fax

Practice location:
  • Phone: 352-895-5457
  • Fax:
Mailing address:
  • Phone: 352-895-5457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN2152622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: