Provider Demographics
NPI:1881821833
Name:JENKS, LAURA BETH (PHAR D)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:JENKS
Suffix:
Gender:F
Credentials:PHAR D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 N STATE OF FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8210
Mailing Address - Country:US
Mailing Address - Phone:423-975-0597
Mailing Address - Fax:423-764-5167
Practice Address - Street 1:527 N STATE OF FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8210
Practice Address - Country:US
Practice Address - Phone:423-975-0597
Practice Address - Fax:423-975-0597
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist