Provider Demographics
NPI:1417018722
Name:JENKINS, SARAH H (ARNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:H
Last Name:JENKINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N HIATUS RD
Mailing Address - Street 2:STE 160
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3097
Mailing Address - Country:US
Mailing Address - Phone:954-431-9838
Mailing Address - Fax:954-433-7066
Practice Address - Street 1:1000 N HIATUS RD
Practice Address - Street 2:STE 160
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-431-9838
Practice Address - Fax:954-433-7066
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1348262103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1348262OtherLICENSE # ARNP