Provider Demographics
NPI:1730471533
Name:JENKINS, CHRISTY LOUISE (ND)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:LOUISE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 SHERMAN DR STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3963
Mailing Address - Country:US
Mailing Address - Phone:636-724-5605
Mailing Address - Fax:636-724-5685
Practice Address - Street 1:1853 SHERMAN DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-1507
Practice Address - Country:US
Practice Address - Phone:636-724-5605
Practice Address - Fax:636-724-5685
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education