=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790739464
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER ANN LAMBERT C-FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2006
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 46 TOWN CENTER PLZ STE A
-----------------------------------------------------
City | MILL CREEK
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26280-9752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-335-2050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 46 TOWN CENTER PLZ STE A
-----------------------------------------------------
City | MILL CREEK
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26280-9752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-335-2050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 54541
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------