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General NPI Number Information
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NPI Number | 1144734963
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Entity Type | Individual
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Provider Name | LA'WANDA Y. JENKINS DNP, APN, PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2017
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 814 WREN RD STE A
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-2312
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Country | US
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Telephone | 615-851-3063
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Fax | 615-420-6413
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Provider Business Mailing Address
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Address Line | 704 TUCKAHOE DR
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City | MADISON
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State | TN
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Zip | 37115-3429
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Country | US
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Telephone | 615-337-4932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 353093-01
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License Number State | TN
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