Provider Demographics
NPI:1871637413
Name:JENKINS, CYNTHIA E (WHNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:JENKINS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 E 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-1859
Mailing Address - Country:US
Mailing Address - Phone:229-276-2680
Mailing Address - Fax:
Practice Address - Street 1:111 E 24TH AVE
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3834
Practice Address - Country:US
Practice Address - Phone:229-276-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN032461363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health