Provider Demographics
NPI:1346509767
Name:JENKINS, ELIZABETH AUSTIN (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:AUSTIN
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 1:110 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-5942
Mailing Address - Country:US
Mailing Address - Phone:615-601-8599
Mailing Address - Fax:
Practice Address - Street 1:155 HEALTH WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2658
Practice Address - Country:US
Practice Address - Phone:931-473-5394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily