Provider Demographics
NPI:1821031733
Name:LAMBERT, JENNIFER (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:HILDEBRAN
Mailing Address - State:NC
Mailing Address - Zip Code:28637-0829
Mailing Address - Country:US
Mailing Address - Phone:828-397-3522
Mailing Address - Fax:828-397-5271
Practice Address - Street 1:107 S CENTER ST
Practice Address - Street 2:
Practice Address - City:HILDEBRAN
Practice Address - State:NC
Practice Address - Zip Code:28637-8304
Practice Address - Country:US
Practice Address - Phone:828-397-3522
Practice Address - Fax:828-397-5271
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC001716930OtherBLUE CROSS OF NORTH CAROLINA ID
NCNCT5264OtherMEDICARE
P50103Medicare UPIN
WV00176930OtherMOUNTAIN STATE BCBS