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General NPI Number Information
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NPI Number | 1366905655
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Entity Type | Individual
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Provider Name | EMILY KATE JENKINS CPNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 435 MARINA DR
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City | GEORGETOWN
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State | SC
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Zip | 29440-2410
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Country | US
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Telephone | 843-833-8595
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Fax |
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Provider Business Mailing Address
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Address Line | 302 GROVE ST
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City | CHARLESTON
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State | SC
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Zip | 29403-3540
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Country | US
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Telephone | 843-864-6080
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 22798
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License Number State | SC
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