Provider Demographics
NPI:1528185022
Name:JENKINS, FRANCES MARY (PA)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:MARY
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 RUSSELL ST.
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2019
Mailing Address - Country:US
Mailing Address - Phone:970-824-8233
Mailing Address - Fax:970-824-2548
Practice Address - Street 1:745 RUSSELL ST.
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2019
Practice Address - Country:US
Practice Address - Phone:970-824-8233
Practice Address - Fax:970-824-2548
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1133363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S81041Medicare UPIN