Provider Demographics
NPI:1841963568
Name:LAMB, JESSICA S (NP-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:LAMB
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 HONEYSUCKLE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-4287
Mailing Address - Country:US
Mailing Address - Phone:334-673-0494
Mailing Address - Fax:334-836-0383
Practice Address - Street 1:1865 HONEYSUCKLE RD STE 3
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4287
Practice Address - Country:US
Practice Address - Phone:334-673-0494
Practice Address - Fax:334-356-1426
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-129099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily