Provider Demographics
NPI:1407371388
Name:JENKINS, DEBRA LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 GILBERT ST STE 2400
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-3306
Mailing Address - Country:US
Mailing Address - Phone:540-231-6557
Mailing Address - Fax:540-231-9660
Practice Address - Street 1:220 GILBERT ST STE 2400
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3306
Practice Address - Country:US
Practice Address - Phone:540-231-6557
Practice Address - Fax:540-231-9660
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175274363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner