Provider Demographics
NPI:1093430530
Name:JENKINS, ALICIA ANN
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11785 HOLGATE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1760
Mailing Address - Country:US
Mailing Address - Phone:254-681-1292
Mailing Address - Fax:
Practice Address - Street 1:11785 HOLGATE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1760
Practice Address - Country:US
Practice Address - Phone:254-681-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant