Healthcare Provider Details

I. General information

NPI: 1891168738
Provider Name (Legal Business Name): CHRISTY L JENKINS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2015
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 ODAY HARRISON RD
MOUNT STERLING OH
43143-9474
US

IV. Provider business mailing address

10500 ODAY HARRISON RD
MOUNT STERLING OH
43143-9474
US

V. Phone/Fax

Practice location:
  • Phone: 740-869-5060
  • Fax: 855-732-2411
Mailing address:
  • Phone: 740-869-5060
  • Fax: 855-732-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN-283737-1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: