Provider Demographics
NPI:1316554454
Name:LAMBERT, JENNIFER THERESA
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:THERESA
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44068-0565
Mailing Address - Country:US
Mailing Address - Phone:814-762-2782
Mailing Address - Fax:
Practice Address - Street 1:5778 DIBBLE RD APT D
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44048-9812
Practice Address - Country:US
Practice Address - Phone:216-469-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide