Provider Demographics
NPI:1659775534
Name:LAMBERT, JOANNA L (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:L
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:L
Other - Last Name:LATKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-2670
Mailing Address - Country:US
Mailing Address - Phone:815-935-9394
Mailing Address - Fax:815-935-1187
Practice Address - Street 1:1701 E COURT ST
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2670
Practice Address - Country:US
Practice Address - Phone:815-935-9394
Practice Address - Fax:815-935-1187
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily