Provider Demographics
NPI:1780303289
Name:JENKINS, MARY ALDEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ALDEN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2703 BARCODY RD SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-2214
Mailing Address - Country:US
Mailing Address - Phone:205-261-1630
Mailing Address - Fax:
Practice Address - Street 1:2703 BARCODY RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-2214
Practice Address - Country:US
Practice Address - Phone:205-261-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant