Provider Demographics
NPI:1063143030
Name:LANOFF, JENNIFER LOUISE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:LANOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 QUESADA ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1662
Mailing Address - Country:US
Mailing Address - Phone:202-744-4925
Mailing Address - Fax:
Practice Address - Street 1:1133 21ST ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3324
Practice Address - Country:US
Practice Address - Phone:202-331-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2023-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184504363LW0102X
MDR248682363LW0102X
DCNP1059395363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health