Provider Demographics
NPI:1811260128
Name:JENKINS, SHAMIKA N (RN)
Entity type:Individual
Prefix:MS
First Name:SHAMIKA
Middle Name:N
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-5853
Mailing Address - Country:US
Mailing Address - Phone:419-806-5206
Mailing Address - Fax:
Practice Address - Street 1:5732 HILL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5853
Practice Address - Country:US
Practice Address - Phone:419-806-5206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704309494163WC2100X, 163WW0000X, 163WD0400X, 163WC1600X, 163WE0900X, 163WA0400X, 163WA2000X, 163WP2201X, 163WC1500X, 163W00000X, 163WC0400X, 163WH1000X, 163WH0200X, 163WX1500X
OHPN.116073164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care