Provider Demographics
NPI:1699389403
Name:LAMBERT, JACQUELINE (CLC,CCE,CD)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:CLC,CCE,CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 1/2 HITER RD
Mailing Address - Street 2:
Mailing Address - City:MERIGOLD
Mailing Address - State:MS
Mailing Address - Zip Code:38759-9778
Mailing Address - Country:US
Mailing Address - Phone:662-402-6611
Mailing Address - Fax:
Practice Address - Street 1:449 1/2 HITER RD
Practice Address - Street 2:
Practice Address - City:MERIGOLD
Practice Address - State:MS
Practice Address - Zip Code:38759-9778
Practice Address - Country:US
Practice Address - Phone:662-402-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula