Provider Demographics
NPI:1376731349
Name:JENKINSON, HALEY (RN)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:JENKINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CUTLER FARM RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7804
Mailing Address - Country:US
Mailing Address - Phone:508-287-5212
Mailing Address - Fax:
Practice Address - Street 1:8 CUTLER FARM RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7804
Practice Address - Country:US
Practice Address - Phone:508-287-5212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272346163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse