GRACIE LATRICE JENKINS NPI 1023967973

NPI Information

  • NPI: 1023967973
  • Provider Name: GRACIE LATRICE JENKINS
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 3605 LIGHT PORT WAY
    KISSIMMEE, FL
    ZIP 34746
  • Phone: (689) 239-9633

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NPI Details

Gracie Latrice Jenkins is a family medicine in Kissimmee, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Gracie Latrice Jenkins NPI is 1023967973. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3605 LIGHT PORT WAY
KISSIMMEE, FL
ZIP 34746-842
Phone: (689) 239-9633

The enumeration date for this NPI number is 1/23/2026 and was last updated on 1/23/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineAPRN11045076FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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