Lenfestey-Demont, Jacqueline Sue
Lenfestey-Demont, Jacqueline Sue is an individual health care provider with primary practice located at 1215 Lawn Ave Ste 120, Elkhart IN 46514-2450. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Oncology. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Lenfestey-Demont, Jacqueline Sue can be contacted via phone (574) 523-2733.Contact Information
Primary practice address
1215 Lawn Ave Ste 120
Elkhart IN 46514-2450
Phone: (574) 523-2733
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4704255722 | Michigan |
Physician Assistants & Advanced Practice Nursing Providers / Oncology | 364SX0200X | 71002535A | Indiana |
Physician Assistants & Advanced Practice Nursing Providers / Oncology | 364SX0200X | 70000200A | Indiana |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71002535A | Indiana |
Profile Details
NPI number | 1578689782 |
---|---|
LBN Legal business name | Lenfestey-Demont, Jacqueline Sue |
Credentials | MSN, APRN, CNS |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 21st, 2007 |
Last updated | May 1st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1578689782 | NPPES |
Indiana | MEDICAID | 200862570 |
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