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General NPI Number Information
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NPI Number | 1487352332
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Entity Type | Individual
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Provider Name | CHARNEL NICOLE JENKINS
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Gender | Female
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 7108 MEADOWBROOK DR
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City | FORT WORTH
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State | TX
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Zip | 76112-5326
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Country | US
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Telephone | 214-930-6077
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Fax | 817-587-1950
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Provider Business Mailing Address
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Address Line | PO BOX 25571
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City | FORT WORTH
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State | TX
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Zip | 76124-2571
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Country | US
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Telephone | 214-930-6077
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Fax | 817-587-1950
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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Taxonomy #4
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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Taxonomy #5
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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Taxonomy #8
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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Taxonomy #9
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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Taxonomy #10
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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Taxonomy #11
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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