Provider Demographics
NPI:1871992388
Name:LOTTER, JENNIFER LAUREN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:LOTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NATIONAL INSTITUTES OF HEALTH
Mailing Address - Street 2:10 CENTER DRIVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892
Mailing Address - Country:US
Mailing Address - Phone:301-443-3481
Mailing Address - Fax:301-402-3088
Practice Address - Street 1:NATIONAL INSTITUTES OF HEALTH 10 CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-5826
Practice Address - Country:US
Practice Address - Phone:301-443-3481
Practice Address - Fax:301-402-3088
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05439363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical