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NPI Code Detail

MEDICARE: DR. DEBORAH SUE JENKS DNP, PMHNP-BC, FNP-C

MEDICARE:  DR. DEBORAH SUE JENKS  DNP, PMHNP-BC, FNP-C
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
1363LF0000XFamily Nurse Practitioner5009986NC
2101YM0800XMental Health CounselorS4461NC
3363LF0000XFamily Nurse Practitioner500986NC
4363LP0808XPsychiatric/Mental Health Nurse Practitioner0024175505VA
5363LP0808XPsychiatric/Mental Health Nurse Practitioner5009986NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15009986OTHERNCNORTH CAROLINA BOARD OF NURSING
20024175505OTHERVAVIRGINA BOARD OF NURSING
30024175505OTHERNCNURSE PRACTITIONER
44461SOTHERNCNORTH CAROLINA BOARD OF PROFESSIONAL COUNSELORS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871550491
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH SUE JENKS DNP, PMHNP-BC, FNP-C
Provider Business Mailing Address
First Line : 14057 US HIGHWAY 17 STE 200
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-3793
Country : US
Telephone Number : 910-821-1418
Fax Number : 866-860-0997
Provider Business Practice Location Address
First Line : 14057 US HIGHWAY 17 STE 200
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-3793
Country : US
Telephone Number : 910-821-1418
Fax Number : 866-860-0997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 01/11/2023

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