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NPI Code Detail

MEDICARE: JESSI RENEE JENKINS

MEDICARE: JESSI RENEE 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
1163W00000XRegistered Nurse355393NC
2363LF0000XFamily Nurse Practitioner5024019NC

General Provider Information

NPI Number : 1578433124
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSI RENEE JENKINS
Provider Business Mailing Address
First Line : 2025 FRONTIS PLAZA BLVD STE 100
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-5663
Country : US
Telephone Number : 336-718-6199
Fax Number :
Provider Business Practice Location Address
First Line : 2025 FRONTIS PLAZA BLVD STE 100
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-5663
Country : US
Telephone Number : 336-718-6199
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2025
Last Update Date : 06/01/2026

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Directions to “ JESSI RENEE JENKINS ” Practice Location

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