Provider Demographics
NPI:1184484487
Name:JENKINS, TORIA LASCHELLE (N/A)
Entity type:Individual
Prefix:
First Name:TORIA
Middle Name:LASCHELLE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 TRADEWINDS DR
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-9664
Mailing Address - Country:US
Mailing Address - Phone:989-895-5273
Mailing Address - Fax:
Practice Address - Street 1:555 TRADEWINDS DR APT 6
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-9669
Practice Address - Country:US
Practice Address - Phone:989-316-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider