Provider Demographics
NPI:1194349605
Name:JENKINS, GAIL L
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:L
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 1:544 FIELDSTREAM WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6955
Mailing Address - Country:US
Mailing Address - Phone:888-931-1977
Mailing Address - Fax:888-931-1977
Practice Address - Street 1:544 FIELDSTREAM WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6955
Practice Address - Country:US
Practice Address - Phone:888-931-1977
Practice Address - Fax:888-931-1977
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-31
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies