Provider Demographics
NPI:1740804749
Name:JINADU, LAWRETTA OROBOSA (CRNP-PMH)
Entity Type:Individual
Prefix:MRS
First Name:LAWRETTA
Middle Name:OROBOSA
Last Name:JINADU
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 CANADIAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2090
Mailing Address - Country:US
Mailing Address - Phone:410-449-9142
Mailing Address - Fax:410-341-3397
Practice Address - Street 1:50 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5485
Practice Address - Country:US
Practice Address - Phone:410-449-9142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207274363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health