Provider Demographics
NPI:1891183968
Name:JENKINS, JEFFREY (RN BSN)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:JENKINS
Suffix:
Gender:M
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-3833
Mailing Address - Country:US
Mailing Address - Phone:607-772-8080
Mailing Address - Fax:607-772-6515
Practice Address - Street 1:66 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3833
Practice Address - Country:US
Practice Address - Phone:607-772-8080
Practice Address - Fax:607-772-6515
Is Sole Proprietor?:No
Enumeration Date:2014-12-24
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY433126-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health