Individual provider Active NPI

Evelin A Jenkins, RN

  • School Registered Nurse
  • Glendale, AZ
National Provider Identifier
1063182202
Registry record updated Sep 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN126875 Issued in AZ
Practice address
5805 W Alameda Rd
Glendale, AZ 85310-3601
Phone
(623) 445-5510
NPI assigned
Sep 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN126875 AZ Primary

Addresses

Primary practice location

5805 W Alameda Rd
Glendale, AZ 85310-3601

Mailing address

23111 N 67TH Ave
Glendale, AZ 85310-5728
Phone (602) 663-7616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN126875AZMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1063182202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105728",
            "telephone_number": "602-663-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 W ALAMEDA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103601",
            "telephone_number": "623-445-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "EVELIN",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-19",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN126875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.