Provider Demographics
NPI:1356742043
Name:JENKINS, QUALYNN S (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:QUALYNN
Middle Name:S
Last Name:JENKINS
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:QUA'LYNN
Other - Middle Name:S
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3601 GERSTNER MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-3231
Mailing Address - Country:US
Mailing Address - Phone:337-475-9500
Mailing Address - Fax:337-475-9599
Practice Address - Street 1:3601 GERSTNER MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-3231
Practice Address - Country:US
Practice Address - Phone:337-475-9500
Practice Address - Fax:337-475-9599
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily