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General NPI Number Information
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NPI Number | 1205307287
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Entity Type | Individual
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Provider Name | RICHELLE DIELOIS JENKINS-GARRETT MSN, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 6140 S BROADWAY
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City | LORAIN
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State | OH
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Zip | 44053-3821
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Country | US
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Telephone | 440-233-7232
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 JEFFERSON AVE
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City | TOLEDO
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State | OH
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Zip | 43604-7101
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Country | US
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Telephone | 513-853-8520
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.023402
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN.429564
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4044024
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License Number State | KY
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