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NPI Code Detail

MEDICARE: JENNA LARKINS

MEDICARE:   JENNA  LARKINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner4704263873MI

General Provider Information

NPI Number : 1134581994
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA LARKINS
Provider Business Mailing Address
First Line : 8680 W GRAND RIVER AVE
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-2327
Country : US
Telephone Number : 810-227-5008
Fax Number :
Provider Business Practice Location Address
First Line : 8680 W GRAND RIVER AVE
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-2327
Country : US
Telephone Number : 810-227-5008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2016
Last Update Date : 03/21/2017

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Directions to “ JENNA LARKINS ” Practice Location

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