Provider Demographics
NPI:1578351532
Name:GOVAN-JENKINS, WANDA YYONNETTE (DNP, MBA, MS, RN)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:YYONNETTE
Last Name:GOVAN-JENKINS
Suffix:
Gender:F
Credentials:DNP, MBA, MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10714 WACO DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4672
Mailing Address - Country:US
Mailing Address - Phone:301-806-1191
Mailing Address - Fax:
Practice Address - Street 1:10714 WACO DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4672
Practice Address - Country:US
Practice Address - Phone:301-806-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118226163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice