Provider Demographics
NPI:1831231372
Name:JENKINS, CATHRYN LYNN (NP)
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:LYNN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4125
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-4125
Mailing Address - Country:US
Mailing Address - Phone:812-537-8241
Mailing Address - Fax:812-537-1041
Practice Address - Street 1:5836 STATE ROUTE 133
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8510
Practice Address - Country:US
Practice Address - Phone:260-483-9091
Practice Address - Fax:260-483-9196
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006694A363LA2200X
OHNS02114364SC0200X
OHAPRN.CNP.022201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2926203Medicaid
OHJENS04141Medicare PIN