Jennifer Marie Legg, LPN

Individual provider Active NPI Licensed Practical Nurse · Lake Station, IN

NPI 1699043190 · NPPES record last updated Dec 12, 2011

Key facts

NPI
1699043190
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
27067504A (IN)
Practice address
2075 Ripley St
Lake Station, IN 46405-1161
Phone
(219) 962-5311
NPI assigned
Dec 12, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27067504AINMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27067504A IN Yes

Addresses

Primary practice location

2075 Ripley St
Lake Station, IN 46405-1161

Mailing address

8400 Louisiana St
Merrillville, IN 46410-6385
Phone (219) 757-1928

Other providers in Lake Station, IN

All providers in Lake Station, IN · Licensed Practical Nurse in Indiana

Sources for this page

Verify at the official NPI Registry.