Provider Demographics
NPI:1194927830
Name:LEMMON, JENNY R (BSN PHN)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:R
Last Name:LEMMON
Suffix:
Gender:F
Credentials:BSN PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-4402
Mailing Address - Country:US
Mailing Address - Phone:530-257-7205
Mailing Address - Fax:530-251-2668
Practice Address - Street 1:1445 BUNYAN RD
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3142
Practice Address - Country:US
Practice Address - Phone:530-251-8183
Practice Address - Fax:530-251-2668
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49181163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health