Provider Demographics
NPI:1801412887
Name:JENKS, SAVANNA MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:MARIE
Last Name:JENKS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:M
Other - Last Name:JENKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:811 OLD LEWISBURG HWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-8132
Mailing Address - Country:US
Mailing Address - Phone:931-446-2771
Mailing Address - Fax:
Practice Address - Street 1:915 S GARDEN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3205
Practice Address - Country:US
Practice Address - Phone:931-548-8090
Practice Address - Fax:931-584-8110
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN168820163W00000X
TN27807363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse