Doctor Name: | JENNIFER WHETSTONE LANEHART |
NPI Number: | 1720185754 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | R858224 |
Business Practice Address: | 451 Bank St Woodville, MS - 396696000 |
Business Phone Number: | 6018883421 |
Business Fax Number: | 6018883685 |
Mailing Address: | Po Box 74, WOODVILLE |
State: | MS |
Postal Code: | 396690074 |
Phone Number: | 6018886181 |
Fax Number: | 6018883685 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 06/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R858224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |