Provider Demographics
NPI:1679817662
Name:LANIER, JENNIFER LEE (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:LANIER
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 1:8722 GINGERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-7906
Mailing Address - Country:US
Mailing Address - Phone:513-571-1691
Mailing Address - Fax:
Practice Address - Street 1:8722 GINGERWOOD CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-7906
Practice Address - Country:US
Practice Address - Phone:513-571-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150938164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH150938OtherOHIO BOARD OF NURSING