Jenks, Elisa R

Jenks, Elisa R is an individual health care provider with primary practice located at 1120 15Th Street Augusta University , Augusta GA 30912-0001. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Midwife, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Jenks, Elisa R can be contacted via phone (706) 721-2688.

Contact Information

Primary practice address
1120 15Th Street Augusta University Augusta GA 30912-0001
Phone: (706) 721-2688
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X CNM05484 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN214715 Georgia

Profile Details

NPI number 1104484443
LBN Legal business name Jenks, Elisa R
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2019
Last updated Jun 20th, 2019 - about 6 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104484443 NPPES
Georgia MEDICAID CNM05484

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