Provider Demographics
NPI:1780674150
Name:JENKINS, NATALIE L (ARNPC MSN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:JENKINS
Suffix:
Gender:F
Credentials:ARNPC MSN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 690609
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0609
Mailing Address - Country:US
Mailing Address - Phone:407-846-7546
Mailing Address - Fax:321-206-5419
Practice Address - Street 1:2205 NORTH BLVD W
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8933
Practice Address - Country:US
Practice Address - Phone:407-846-7546
Practice Address - Fax:321-206-5419
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9182461363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007854900Medicaid
U1120ZMedicare ID - Type Unspecified
FL007854900Medicaid