Provider Demographics
NPI:1689973000
Name:JENKINS, JULIE W (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:W
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4374 NEW TOWN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2865
Mailing Address - Country:US
Mailing Address - Phone:757-253-5757
Mailing Address - Fax:757-510-9063
Practice Address - Street 1:4374 NEW TOWN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2865
Practice Address - Country:US
Practice Address - Phone:757-253-5757
Practice Address - Fax:757-510-9063
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC190679363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics