Provider Demographics
NPI:1215076070
Name:LANOIS, JAIME R (AUD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:R
Last Name:LANOIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 E SEMINOLE ST STE 530
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2227
Mailing Address - Country:US
Mailing Address - Phone:417-820-5071
Mailing Address - Fax:
Practice Address - Street 1:1229 E SEMINOLE ST STE 530
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2227
Practice Address - Country:US
Practice Address - Phone:417-820-5071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003011036231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR195410720Medicaid
MO206689OtherMO BLUE SHIELD
MO431560263OtherTRICARE
MOP01129109OtherRR MCR
MO1215076070Medicaid
MO132680383Medicare UPIN
AR195410720Medicaid