Healthcare Provider Details

I. General information

NPI: 1790739464
Provider Name (Legal Business Name): JENNIFER ANN LAMBERT C-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 TOWN CENTER PLZ STE A
MILL CREEK WV
26280-9752
US

IV. Provider business mailing address

46 TOWN CENTER PLZ STE A
MILL CREEK WV
26280-9752
US

V. Phone/Fax

Practice location:
  • Phone: 304-335-2050
  • Fax:
Mailing address:
  • Phone: 304-335-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number54541
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: