Provider Demographics
NPI:1699105999
Name:JENKINS, CHELSEA (LPN)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3185 FORESTVIEW ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2722
Mailing Address - Country:US
Mailing Address - Phone:330-546-2128
Mailing Address - Fax:
Practice Address - Street 1:3185 FORESTVIEW ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2722
Practice Address - Country:US
Practice Address - Phone:330-546-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.152725-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse