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General NPI Number Information
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NPI Number | 1982499950
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Entity Type | Individual
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Provider Name | HALEY PAIGE JENKINS
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 435 N CEDAR AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2422
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Country | US
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Telephone | 931-526-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 5109 GERMANO RD SE
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City | CARROLLTON
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State | OH
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Zip | 44615-9556
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Country | US
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Telephone | 330-705-9756
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 38457
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License Number State | TN
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