Provider Demographics
NPI:1336424423
Name:MARTIN, JENNIFER LAHETA (MED, ACSM-RCEP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAHETA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MED, ACSM-RCEP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:LAHETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, ACSM-RCEP
Mailing Address - Street 1:2301 ERWIN RD
Mailing Address - Street 2:BOX # 100,000 (PEDIATRIC PULMONARY TESTING LAB)
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4699
Mailing Address - Country:US
Mailing Address - Phone:919-668-3190
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:BOX # 100,000 (PEDIATRIC PULMONARY TESTING LAB)
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-668-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist