Most Relevant Information
Provider Data
| NPI Number: | 1003561465 |
| Provider Name: | TINA MARIE JENKINS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/15/2022 |
| Last Updated: | 02/15/2022 |
Provider Practice Location
1226 INDEPENDENCE AVE
KENNETT
MO
638571316
Practice Location Phone/Fax
| Phone: | 5735592380 |
| Fax: |
Provider Mailing Location
1226 INDEPENDENCE AVE
KENNETT
MO
638571316
Provider Mailing Phone/Fax
| Phone: | 5735592380 |
| Fax: |