Provider Demographics
NPI:1043775554
Name:JENKINS, JAMIE PARLETT (NP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:PARLETT
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2888
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:
Practice Address - Street 1:235 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:VA
Practice Address - Zip Code:22851-4112
Practice Address - Country:US
Practice Address - Phone:540-778-4259
Practice Address - Fax:540-778-1249
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024177246OtherLICENSE