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NPI Code Detail

MEDICARE: SAMANTHA JEWEL JENKINS

MEDICARE: SAMANTHA JEWEL 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
1164W00000XLicensed Practical NurseP56697IA

General Provider Information

NPI Number : 1679438923
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA JEWEL JENKINS
Provider Business Mailing Address
First Line : 2213 2ND ST
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-1205
Country : US
Telephone Number : 319-358-2406
Fax Number :
Provider Business Practice Location Address
First Line : 2213 2ND ST
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-1205
Country : US
Telephone Number : 319-358-2406
Fax Number : 319-358-9276
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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Directions to “ SAMANTHA JEWEL JENKINS ” Practice Location

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