Healthcare Provider Details

I. General information

NPI: 1225692601
Provider Name (Legal Business Name): RIKKI B JENKINS IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7381 PRAIRIE FALCON RD STE 120
LAS VEGAS NV
89128-0812
US

IV. Provider business mailing address

2564 QUAIL CANYON AVE
HENDERSON NV
89074-7054
US

V. Phone/Fax

Practice location:
  • Phone: 702-741-7570
  • Fax:
Mailing address:
  • Phone: 702-741-7570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: