Provider Demographics
NPI:1477343895
Name:JENKINS, ROCIO A (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:A
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:ROCIO
Other - Middle Name:AIMEE
Other - Last Name:CACERES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:516 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2549
Mailing Address - Country:US
Mailing Address - Phone:917-261-8250
Mailing Address - Fax:
Practice Address - Street 1:508 MOUNT PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-2904
Practice Address - Country:US
Practice Address - Phone:862-229-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJE26NJ15324200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health