Provider Demographics
NPI:1548497688
Name:JENKINS, PATRICIA LYNN (RNC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RNC
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 2364
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97528-0207
Mailing Address - Country:US
Mailing Address - Phone:541-415-0465
Mailing Address - Fax:
Practice Address - Street 1:28186 REDWOOD HIGHWAY
Practice Address - Street 2:
Practice Address - City:CAVE JUNCTION
Practice Address - State:OR
Practice Address - Zip Code:97523
Practice Address - Country:US
Practice Address - Phone:541-415-0465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200240384RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health