Provider Demographics
NPI:1053629410
Name:JENKINS, TALIAH (CD(CBI))
Entity Type:Individual
Prefix:MRS
First Name:TALIAH
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CD(CBI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 E 112TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-3272
Mailing Address - Country:US
Mailing Address - Phone:720-276-8982
Mailing Address - Fax:
Practice Address - Street 1:1440 E 112TH PL
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-3272
Practice Address - Country:US
Practice Address - Phone:720-276-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula