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NPI Code Detail

MEDICARE: JENIFFER JENKINS

MEDICARE: JENIFFER 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 TechnicianCB60876439WA
2103K00000XBehavior AnalystBA61114143WA

General Provider Information

NPI Number : 1427696228
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENIFFER JENKINS
Provider Business Mailing Address
First Line : 16916 CEDARWOOD DR
Second Line :
City : EDMOND
State : OK
Zip : 73012-6713
Country : US
Telephone Number : 360-820-7878
Fax Number :
Provider Business Practice Location Address
First Line : 14828 SERENITA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-2028
Country : US
Telephone Number : 855-782-7822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2019
Last Update Date : 01/08/2024

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Directions to “ JENIFFER JENKINS ” Practice Location

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