Provider Demographics
NPI:1104058296
Name:JENKINS, CHRISTIANA OMOWUNMI
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:OMOWUNMI
Last Name:JENKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 S COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2927
Mailing Address - Country:US
Mailing Address - Phone:469-583-9690
Mailing Address - Fax:817-275-6340
Practice Address - Street 1:3311 S COLLINS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2927
Practice Address - Country:US
Practice Address - Phone:469-583-9690
Practice Address - Fax:817-275-6340
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health