Healthcare Provider Details

I. General information

NPI: 1275499238
Provider Name (Legal Business Name): JENNIFER LEMKE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COUNTRY MEADOWS LN
COVINGTON GA
30014-0421
US

IV. Provider business mailing address

25 COUNTRY MEADOWS LN
COVINGTON GA
30014-0421
US

V. Phone/Fax

Practice location:
  • Phone: 678-977-0364
  • Fax:
Mailing address:
  • Phone: 678-977-0364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP207089
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN207089
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: