Provider Demographics
NPI:1548151996
Name:LAMER, JACLYN RENE (CPNP-AC, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:RENE
Last Name:LAMER
Suffix:
Gender:F
Credentials:CPNP-AC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 SAINT CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-6335
Mailing Address - Country:US
Mailing Address - Phone:309-267-5227
Mailing Address - Fax:
Practice Address - Street 1:2205 STATE ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-3936
Practice Address - Country:US
Practice Address - Phone:309-648-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022837363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health