Provider Demographics
NPI:1306908421
Name:LEMERT, JENNIFER L (CRNP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:LEMERT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 876774
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6774
Mailing Address - Country:US
Mailing Address - Phone:907-745-8100
Mailing Address - Fax:
Practice Address - Street 1:2490 S WOODWORTH LOOP STE 450
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7407
Practice Address - Country:US
Practice Address - Phone:907-745-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK606363LF0000X
PASP010222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP06061Medicaid
AK161160Medicare PIN
AKNP06062Medicaid