MEDICARE: FRIDEA JENKINS MSN, APRN, PMHNP-C

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	PMH01260019	GA

General Provider Information

NPI Number	:	1174489603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRIDEA JENKINS MSN, APRN, PMHNP-C

Provider Business Mailing Address
First Line	:	786 IVY BROOK WAY
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-5528
Country	:	US
Telephone Number	:	478-952-9984
Fax Number	:

Provider Business Practice Location Address
First Line	:	786 IVY BROOK WAY
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-5528
Country	:	US
Telephone Number	:	478-952-9984
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	03/26/2026

Similar Medicare Providers

1700360831 — HOUSTON COUNTY HEALTH DEPARTMENT
Practice Location Address:

3920 ARKWRIGHT RD STE 415
MACON, GA
31210-1731

Practice Phone: 833-789-5302
Practice Fax: 478-238-9417

1053339168 — DR. RANA K MUNNA M.D.
Practice Location Address:

107 PRESTON CT
MACON, GA
31210

Practice Phone: 478-238-0771
Practice Fax: 478-238-6688

1013858083 — POSITIVE BEHAVIOR SUPPORTS
Practice Location Address:

500 NORTHSIDE CROSSING,MACON , STE A
MACON, GA
31210-2377

Practice Phone: 185-583-2672
Practice Fax:

1790136836 — MR. RANDALL CLAY CANNON PT
Practice Location Address:

3708 NORTHSIDE DR
MACON, GA
31210-2404

Practice Phone: 478-745-4206
Practice Fax: 478-832-6506

1366290843 — RAYMOND ROOT FNP-C
Practice Location Address:

5791 ZEBULON RD STE A
MACON, GA
31210-2397

Practice Phone: 478-787-0410
Practice Fax:

1588511810 — KATIE BLANKENSHIP
Practice Location Address:

500 NORTHSIDE XING STE A
MACON, GA
31210-2377

Practice Phone: 855-832-6727
Practice Fax:

Directions to “ FRIDEA JENKINS MSN, APRN, PMHNP-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.