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General NPI Number Information
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NPI Number | 1265283642
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Entity Type | Individual
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Provider Name | ERICK W JENKINS NP
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Gender | Male
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 1780 DOOLITTLE AVE
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City | NAVAL AIR STATION JRB
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State | TX
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Zip | 76127-1134
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Country | US
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Telephone | 739-778-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1780 DOOLITTLE AVE
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City | NAVAL AIR STATION JRB
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State | TX
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Zip | 76127-1134
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Country | US
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Telephone |
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 831820
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1172155
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License Number State | TX
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