Provider Demographics
NPI:1386089910
Name:JENKINS, LEAH NICHOLE (ACNP-BC)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:NICHOLE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 MAIN ST
Mailing Address - Street 2:P.O. BOX 312
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-9153
Mailing Address - Country:US
Mailing Address - Phone:270-522-2555
Mailing Address - Fax:270-522-2550
Practice Address - Street 1:252 MAIN ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-9153
Practice Address - Country:US
Practice Address - Phone:270-522-2555
Practice Address - Fax:270-522-2550
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008040363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care