Provider Demographics
NPI:1760115174
Name:DINKENS, SENTREILA COLLEN (RN)
Entity Type:Individual
Prefix:
First Name:SENTREILA
Middle Name:COLLEN
Last Name:DINKENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-9436
Mailing Address - Country:US
Mailing Address - Phone:863-326-8325
Mailing Address - Fax:
Practice Address - Street 1:4340 DINNER LAKE BLVD
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33859-2129
Practice Address - Country:US
Practice Address - Phone:863-326-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9347185163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse