Provider Demographics
NPI:1487961561
Name:JENKINS, NANNETTE CHRISTINE (CNM)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:CHRISTINE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 BUCKEYSTOWN PIKE UNIT 69
Mailing Address - Street 2:
Mailing Address - City:BUCKEYSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21717-1001
Mailing Address - Country:US
Mailing Address - Phone:240-341-4974
Mailing Address - Fax:772-209-7667
Practice Address - Street 1:3620 BUCKEYSTOWN PIKE UNIT 69
Practice Address - Street 2:
Practice Address - City:BUCKEYSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21717-1001
Practice Address - Country:US
Practice Address - Phone:240-341-4974
Practice Address - Fax:772-209-7667
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife