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General NPI Number Information
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NPI Number | 1841288040
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Entity Type | Individual
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Provider Name | IRMA N JENKINS CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 1601 NEW CASTLE RD
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City | FORREST CITY
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State | AR
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Zip | 72335-2218
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Country | US
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Telephone | 870-261-0513
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Fax | 870-261-0126
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Provider Business Mailing Address
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Address Line | 6286 BRIARCREST AVE
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City | MEMPHIS
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State | TN
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Zip | 38120-4023
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Country | US
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Telephone | 901-747-4624
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Fax | 901-261-2542
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C00494
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R015393
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | P000113
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License Number State | AR
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