Healthcare Provider Details

I. General information

NPI: 1356862965
Provider Name (Legal Business Name): JENNIFER HELEN LORAN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER HELEN PALMER

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 819 BOX 18
FPO AE
09645-0001
US

IV. Provider business mailing address

PSC 819 BOX 18
FPO AE
09645-0001
US

V. Phone/Fax

Practice location:
  • Phone: 314-727-3524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number60775607
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: