Provider Demographics
NPI:1962817650
Name:JENKINS, CATHERINE ALYSIA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ALYSIA
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1038
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1038
Mailing Address - Country:US
Mailing Address - Phone:706-660-6148
Mailing Address - Fax:706-660-2843
Practice Address - Street 1:7830 VETERANS PKWY
Practice Address - Street 2:SUITE H
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4972
Practice Address - Country:US
Practice Address - Phone:706-320-8881
Practice Address - Fax:706-221-3594
Is Sole Proprietor?:No
Enumeration Date:2014-06-22
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN183344163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse