Provider Demographics
NPI:1891756409
Name:JENKINS, AMY PAYETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:PAYETTE
Last Name:JENKINS
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 1:5150 BLUESTEM DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1310
Mailing Address - Country:US
Mailing Address - Phone:719-572-9990
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIRCLE
Practice Address - Street 2:USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-526-7844
Practice Address - Fax:719-526-7984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN166030163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency