Healthcare Provider Details

I. General information

NPI: 1588525257
Provider Name (Legal Business Name): JENNIFER LENARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 14TH AVE STE A1
GULFPORT MS
39501-5101
US

IV. Provider business mailing address

400 PASS RD UNIT B1
GULFPORT MS
39507-2901
US

V. Phone/Fax

Practice location:
  • Phone: 228-609-0747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: