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NPI Code Detail

MEDICARE: GRETCHEN HEIDI JENKINS FNP-C

MEDICARE: GRETCHEN HEIDI JENKINS FNP-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
1367A00000XAdvanced Practice Midwife090000144AIN
2363L00000XNurse Practitioner71003049AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295985828
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRETCHEN HEIDI JENKINS FNP-C
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 128 N RANDOLPH ST
Second Line :
City : GARRETT
State : IN
Zip : 46738-1138
Country : US
Telephone Number : 260-235-7655
Fax Number : 260-357-0373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 10/20/2022

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Directions to “ GRETCHEN HEIDI JENKINS FNP-C” Practice Location

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