Provider Demographics
NPI:1023134194
Name:THOMPSON JENKINS, SANDRA A (LPN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:A
Last Name:THOMPSON JENKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 US ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH HERO
Mailing Address - State:VT
Mailing Address - Zip Code:05474-9716
Mailing Address - Country:US
Mailing Address - Phone:802-372-4241
Mailing Address - Fax:
Practice Address - Street 1:38 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH HERO
Practice Address - State:VT
Practice Address - Zip Code:05486-4900
Practice Address - Country:US
Practice Address - Phone:802-372-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0250005417164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse