Provider Demographics
NPI:1194178772
Name:JENKINS, JULIE (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-240-2337
Mailing Address - Fax:334-293-6859
Practice Address - Street 1:1801 PINE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-0165
Practice Address - Country:US
Practice Address - Phone:334-293-8877
Practice Address - Fax:334-293-6803
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily