Provider Demographics
NPI:1437594371
Name:JENKINS, JOANNE T (RN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:T
Last Name:JENKINS
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 1:1484 CAMP RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-4059
Mailing Address - Country:US
Mailing Address - Phone:843-762-2784
Mailing Address - Fax:843-762-6209
Practice Address - Street 1:1484 CAMP RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-4059
Practice Address - Country:US
Practice Address - Phone:843-762-2784
Practice Address - Fax:843-762-6209
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41873163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool