Provider Demographics
NPI:1710559307
Name:JENKINS, ASHLEY L (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 HIGHWAY 51 S STE B
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:TN
Mailing Address - Zip Code:38011-8018
Mailing Address - Country:US
Mailing Address - Phone:901-441-6448
Mailing Address - Fax:662-673-3452
Practice Address - Street 1:8440 HIGHWAY 51 S STE B
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:TN
Practice Address - Zip Code:38011-8018
Practice Address - Country:US
Practice Address - Phone:901-441-6448
Practice Address - Fax:662-673-3452
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-12-14
Deactivation Date:2023-01-31
Deactivation Code:
Reactivation Date:2023-02-07
Provider Licenses
StateLicense IDTaxonomies
MS897870163W00000X
MS904799363L00000X, 363LP0808X
TN32786363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner