Provider Demographics
NPI:1598453664
Name:JENKINS, CONNECYT (CRNP/AGPCNP-C)
Entity Type:Individual
Prefix:
First Name:CONNECYT
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CRNP/AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 KINGS GATE DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-4676
Mailing Address - Country:US
Mailing Address - Phone:251-422-5155
Mailing Address - Fax:
Practice Address - Street 1:3280 KINGS GATE DR W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618-4676
Practice Address - Country:US
Practice Address - Phone:251-422-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-126484363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology