Provider Demographics
NPI:1861389462
Name:JENNINGS, AMBER LAFFERTY
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LAFFERTY
Last Name:JENNINGS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:LASHMEET
Mailing Address - State:WV
Mailing Address - Zip Code:24733-9780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:865 LOOKOUT RD
Practice Address - Street 2:
Practice Address - City:LASHMEET
Practice Address - State:WV
Practice Address - Zip Code:24733-9780
Practice Address - Country:US
Practice Address - Phone:276-245-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide