Individual
MR. JEFFERY S LAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1824 DORCHESTER CT STE A, GOSHEN, IN 46526-6819
(574) 534-2548
(574) 534-3622
Mailing address
1824 DORCHESTER CT STE A, GOSHEN, IN 46526-6819
(574) 534-2548
(574) 534-3622
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71011080A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300049617
—
IN
Enumeration date
04/07/2021
Last updated
04/24/2023
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