Provider Demographics
NPI:1427644236
Name:LAURENT, JENNIFER LOUISE (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:LAURENT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LOUISE
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10050 BROKEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-9255
Mailing Address - Country:US
Mailing Address - Phone:702-265-7897
Mailing Address - Fax:
Practice Address - Street 1:1001 MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3848
Practice Address - Country:US
Practice Address - Phone:775-443-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist