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NPI Code Detail

MEDICARE: EMILY JENKINS

MEDICARE: EMILY JENKINS
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
1106S00000XBehavior Technician22-227301TN

General Provider Information

NPI Number : 1356041719
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JENKINS
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4232 INISBROOK WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37938-2021
Country : US
Telephone Number : 702-767-4605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 03/06/2023

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Directions to “ EMILY JENKINS ” Practice Location

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