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NPI Code Detail

MEDICARE: MS. CAROL A JENKINSON NURSE PRACTITIONER

MEDICARE: MS. CAROL A JENKINSON NURSE PRACTITIONER
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
1363L00000XNurse PractitionerR0061574OK

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 : 1609865500
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL A JENKINSON NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 2501 N BLACKWELDER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-1402
Country : US
Telephone Number : 405-208-6010
Fax Number : 405-208-6016
Provider Business Practice Location Address
First Line : 2501 N BLACKWELDER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-1402
Country : US
Telephone Number : 405-208-6010
Fax Number : 405-208-6016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 12/03/2013

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