Provider Demographics
NPI:1578978847
Name:JENKINS, LAKEYSHA R (NP)
Entity Type:Individual
Prefix:
First Name:LAKEYSHA
Middle Name:R
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 THIMBLE SHOALS BLVD STE 203A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4512
Mailing Address - Country:US
Mailing Address - Phone:757-775-8837
Mailing Address - Fax:949-561-4700
Practice Address - Street 1:610 THIMBLE SHOALS BLVD STE 203A
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4512
Practice Address - Country:US
Practice Address - Phone:757-775-8837
Practice Address - Fax:949-561-4700
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171647363LA2200X, 363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology