Provider Demographics
NPI:1144870866
Name:JENKINS, JASMINE BURSON (FNP-C)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:BURSON
Last Name:JENKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173260
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59717-3260
Mailing Address - Country:US
Mailing Address - Phone:406-994-2311
Mailing Address - Fax:
Practice Address - Street 1:7TH ST. & GRANT
Practice Address - Street 2:100 SWINGLE BUILDING
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59717
Practice Address - Country:US
Practice Address - Phone:406-994-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-14
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8638762-4405363LF0000X
MTNUR-APRN-LIC-193378363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily