Provider Demographics
NPI:1912879032
Name:JENKINS, TANYA (RN)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 MORRIS FARM DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-8985
Mailing Address - Country:US
Mailing Address - Phone:336-638-5511
Mailing Address - Fax:
Practice Address - Street 1:2216 W MEADOWVIEW RD STE 113
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3401
Practice Address - Country:US
Practice Address - Phone:336-541-8046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC221615163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health