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
State | License ID | Taxonomies |
---|---|---|
MI | 4704309494 | 163WC2100X, 163WW0000X, 163WD0400X, 163WC1600X, 163WE0900X, 163WA0400X, 163WA2000X, 163WP2201X, 163WC1500X, 163W00000X, 163WC0400X, 163WH1000X, 163WH0200X, 163WX1500X |
OH | PN.116073 | 164W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 163WC2100X | Nursing Service Providers | Registered Nurse | Continence Care |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care |
No | 163WD0400X | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No | 163WC1600X | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development |
No | 163WE0900X | Nursing Service Providers | Registered Nurse | Enterostomal Therapy |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | |
No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No | 163WA2000X | Nursing Service Providers | Registered Nurse | Administrator |
No | 163WP2201X | Nursing Service Providers | Registered Nurse | Ambulatory Care |
No | 163WC1500X | Nursing Service Providers | Registered Nurse | Community Health |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management |
No | 163WH1000X | Nursing Service Providers | Registered Nurse | Hospice |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health |
No | 163WX1500X | Nursing Service Providers | Registered Nurse | Ostomy Care |