Provider Demographics
NPI:1528695558
Name:JENKINS, ERIN (NP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5157 E BONANZA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3601
Mailing Address - Country:US
Mailing Address - Phone:702-744-7016
Mailing Address - Fax:
Practice Address - Street 1:5940 S RAINBOW BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2507
Practice Address - Country:US
Practice Address - Phone:702-744-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013960363L00000X, 363LP0808X
VA0024189497363LP0808X, 363LF0000X
NV865509363LF0000X, 363LP0808X
IAG17852363LF0000X
DC500015729363LF0000X, 363LP0808X
IAG178752363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily