Doctor Name: | ERICKA JENKINS |
NPI Number: | 1700149200 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 28209 |
Business Practice Address: | 3687 Veterans Dr Fort Harrison, MT - 596369703 |
Business Phone Number: | 4064477307 |
Business Fax Number: | |
Mailing Address: | 3687 Veterans Dr, P.o. Box 1500 FORT HARRISON |
State: | MT |
Postal Code: | 596369703 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 12/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 28209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |