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General NPI Number Information
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NPI Number | 1194925768
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Entity Type | Individual
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Provider Name | HEATHER JENKINS
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | PSC 482 BOX 1600
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City | FPO
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State | AP
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Zip | 96362-0017
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Country | US
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Telephone | 315-646-7430
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 482 BOX 1600
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City | FPO
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State | AP
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Zip | 96362-0017
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Country | US
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Telephone | 315-646-7430
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 02829
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12642
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License Number State | AZ
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