Holly Jo Jenkins, RN

Individual provider Active NPI Registered Nurse · Alexander, AR

NPI 1093404451 · NPPES record last updated May 2, 2023

Key facts

NPI
1093404451
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R083534 (AR)
Practice address
2510 Crystal Lake Rd
Alexander, AR 72002-9535
Phone
(501) 993-0386
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R083534ARMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R083534 AR Yes

Addresses

Primary practice location

2510 Crystal Lake Rd
Alexander, AR 72002-9535

Mailing address

2510 Crystal Lake Rd
Alexander, AR 72002-9535
Phone (501) 993-0386

Other providers in Alexander, AR

All providers in Alexander, AR · Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.