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General NPI Number Information
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NPI Number | 1306352570
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Entity Type | Individual
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Provider Name | NIKITA L JENKINS BSN, RN, RN-BC
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Gender | Female
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 12/22/2017
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Provider Practice Location Address
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Address Line | 1410 NE 219TH ST
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City | LAWTEY
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State | FL
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Zip | 32058-4387
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Country | US
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Telephone | 904-769-1122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 365
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City | STARKE
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State | FL
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Zip | 32091-0365
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Country | US
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Telephone | 904-769-1122
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 9383636
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License Number State | FL
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