Provider Demographics
NPI:1437927944
Name:JENKINS, MEGAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8458 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2841
Mailing Address - Country:US
Mailing Address - Phone:443-618-9287
Mailing Address - Fax:
Practice Address - Street 1:2411 CROFTON LN UNIT 19
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1304
Practice Address - Country:US
Practice Address - Phone:443-332-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218532363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner