Provider Demographics
NPI:1437671153
Name:JENKINS, ERIC K (APRN)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:K
Last Name:JENKINS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN: SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-267-1603
Mailing Address - Fax:850-622-3342
Practice Address - Street 1:7720 US HIGHWAY 98 W STE 110
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-7231
Practice Address - Country:US
Practice Address - Phone:850-267-1603
Practice Address - Fax:850-622-3342
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9429770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily