Provider Demographics
NPI:1811939671
Name:JENKINS, DEANN (MD)
Entity type:Individual
Prefix:
First Name:DEANN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3602
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-383-7925
Practice Address - Street 1:1938 N WOODLAWN ST STE 400
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-1875
Practice Address - Country:US
Practice Address - Phone:316-660-9600
Practice Address - Fax:316-660-9660
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-226622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4109OtherPREFERRED HEALTH SYSTEMS
KS104461OtherBLUE CROSS BLUE SHIELD
KS104461Medicare ID - Type Unspecified