Provider Demographics
NPI:1740589928
Name:JENKINS, SIMEKO NICOLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:SIMEKO
Middle Name:NICOLE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27515 FORESTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1176
Mailing Address - Country:US
Mailing Address - Phone:216-534-0455
Mailing Address - Fax:
Practice Address - Street 1:27515 FORESTVIEW AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1718
Practice Address - Country:US
Practice Address - Phone:216-534-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-27
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-142946164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse