Provider Demographics
NPI:1013734540
Name:SMITH JENKINS, RONDA
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:
Last Name:SMITH JENKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 WAYNOKA RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2410
Mailing Address - Country:US
Mailing Address - Phone:216-965-7679
Mailing Address - Fax:
Practice Address - Street 1:2155 WAYNOKA RD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2410
Practice Address - Country:US
Practice Address - Phone:121-696-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty