Provider Demographics
NPI:1407635972
Name:JENKINS, CHELSEA DAWN (MLS(ASCP))
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:DAWN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MLS(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E 4800 S
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-4903
Mailing Address - Country:US
Mailing Address - Phone:951-751-1810
Mailing Address - Fax:
Practice Address - Street 1:500 FOOTHILL DR # 11
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:801-584-1203
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT25852937207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine