Provider Demographics
NPI:1376265678
Name:JENKINS, WILLIAM GA
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GA
Last Name:JENKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 CARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1855
Mailing Address - Country:US
Mailing Address - Phone:240-401-7973
Mailing Address - Fax:
Practice Address - Street 1:3105 WACLARK PL SE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1669
Practice Address - Country:US
Practice Address - Phone:202-399-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide