Jenkins, Jacqueline M
Jenkins, Jacqueline M is an individual health care provider with primary practice located at 1160 W Michigan St Ste 100 , Indianapolis IN 46202-5209. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jenkins, Jacqueline M can be contacted via phone (317) 278-1470.Contact Information
Primary practice address
1160 W Michigan St Ste 100
Indianapolis IN 46202-5209
Phone: (317) 278-1470
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1490 | Tennessee |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18003487 | Indiana |
Profile Details
| NPI number | 1639162811 |
|---|---|
| LBN Legal business name | Jenkins, Jacqueline M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639162811 | NPPES |
| Indiana | MEDICAID | 200881460 | |
| Indiana | Other | 1490 | |
| Indiana | MEDICAID | 3598926 |
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