Provider Demographics
NPI:1053748582
Name:JENKINS, RACHAEL MARIE (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:MARIE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:MISS
Other - First Name:RACHAEL
Other - Middle Name:MARIE
Other - Last Name:UNTERREINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:817 S MOUNT AUBURN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6383
Mailing Address - Country:US
Mailing Address - Phone:573-519-4500
Mailing Address - Fax:
Practice Address - Street 1:817 S MOUNT AUBURN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6383
Practice Address - Country:US
Practice Address - Phone:573-519-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013035662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily