Provider Demographics
NPI:1467293944
Name:JENKINS, JAMIE SHANI SHANTEY SHANI (CNA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:SHANI SHANTEY SHANI
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-2077
Mailing Address - Country:US
Mailing Address - Phone:803-678-8561
Mailing Address - Fax:
Practice Address - Street 1:1720 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-2077
Practice Address - Country:US
Practice Address - Phone:803-678-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider