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General NPI Number Information
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NPI Number | 1710508353
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Entity Type | Individual
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Provider Name | JAYCEE LAUREN LOTT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 926 ROSS CLARK CIRCLE
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City | DOTHAN
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State | AL
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Zip | 36303-3072
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Country | US
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Telephone | 229-456-2157
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Fax |
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Provider Business Mailing Address
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Address Line | 926 ROSS CLARK CIRCLE
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City | DOTHAN
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State | AL
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Zip | 36303-3072
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Country | US
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Telephone | 229-456-2157
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN275259
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3-002087
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License Number State | AL
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