Provider Demographics
NPI:1144639154
Name:AMY JENKINS LLC
Entity type:Organization
Organization Name:AMY JENKINS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ADCOX
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-590-7453
Mailing Address - Street 1:413 DEVONIA ST
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2010
Mailing Address - Country:US
Mailing Address - Phone:865-590-7453
Mailing Address - Fax:
Practice Address - Street 1:413 DEVONIA ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2010
Practice Address - Country:US
Practice Address - Phone:865-590-7453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007617363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty