Provider Demographics
NPI:1376380030
Name:JENKINS, SIARRA ANNETTE
Entity type:Individual
Prefix:
First Name:SIARRA
Middle Name:ANNETTE
Last Name: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 1:809 REDFERN CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2709
Mailing Address - Country:US
Mailing Address - Phone:615-775-2737
Mailing Address - Fax:
Practice Address - Street 1:95 WHITE BRIDGE PIKE STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1426
Practice Address - Country:US
Practice Address - Phone:615-570-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health