| Doctor Name: | JACLYN A LANHAM |
| NPI Number: | 1609178755 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 11881NP |
| Business Practice Address: | 5319 Hoag Dr Suite 111 Sheffield Village, OH - 440351494 |
| Business Phone Number: | 4409342272 |
| Business Fax Number: | 4409343416 |
| Mailing Address: | 3004 Hayes Ave, SANDUSKY |
| State: | OH |
| Postal Code: | 448705321 |
| Phone Number: | 4196091112 |
| Fax Number: | 4196091123 |
| NPI Enumeration Date: | 11/23/2010 |
| NPI Last Update Date: | 11/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 11881NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |