Provider Demographics
NPI:1184939340
Name:PINHOLSTER, JENNIFER REBECCA (LMT LPN CLD CCCE CLE)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:REBECCA
Last Name:PINHOLSTER
Suffix:
Gender:F
Credentials:LMT LPN CLD CCCE CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1158
Mailing Address - Country:US
Mailing Address - Phone:478-960-6365
Mailing Address - Fax:
Practice Address - Street 1:4537 FORSYTH RD
Practice Address - Street 2:SUITE D
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4548
Practice Address - Country:US
Practice Address - Phone:478-477-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula