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General NPI Number Information
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NPI Number | 1982205548
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Entity Type | Individual
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Provider Name | AMANDA JENKINS
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Gender | Female
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 12504 US ROUTE 60
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City | ASHLAND
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State | KY
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Zip | 41102-9687
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Country | US
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Telephone | 606-929-9360
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Fax |
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Provider Business Mailing Address
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Address Line | 6029 DEE CT
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City | ASHLAND
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State | KY
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Zip | 41102-8343
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Country | US
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Telephone | 606-694-8081
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 012051
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License Number State | KY
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