Provider Demographics
NPI:1275903197
Name:JENKINS, SHERRIE (C-FNP)
Entity Type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 REGIONAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3551
Mailing Address - Country:US
Mailing Address - Phone:662-234-1476
Mailing Address - Fax:
Practice Address - Street 1:967 REGIONAL CENTER DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3551
Practice Address - Country:US
Practice Address - Phone:662-234-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR864809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily