Provider Demographics
NPI:1386219541
Name:LERCH, JENA (MSN, PMHNP-BC, APRN)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:LERCH
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TEN ROD RD STE E305
Mailing Address - Street 2:
Mailing Address - City:N KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4176
Mailing Address - Country:US
Mailing Address - Phone:401-294-0451
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD STE E305
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4176
Practice Address - Country:US
Practice Address - Phone:401-294-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9480080163W00000X
RIRN70080163W00000X
RIAPRN02871363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse