1225042682 NPI number — MRS. LORI LANE CUMMINGS APRN CPNP

Table of content: MRS. LORI LANE CUMMINGS APRN CPNP (NPI 1225042682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225042682 NPI number — MRS. LORI LANE CUMMINGS APRN CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUMMINGS
Provider First Name:
LORI
Provider Middle Name:
LANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225042682
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1232 SHEPPARD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINDEN
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71055-3460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-377-7116
Provider Business Mailing Address Fax Number:
318-377-9979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1232 SHEPPARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINDEN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71055-3460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-377-7116
Provider Business Practice Location Address Fax Number:
318-377-9979
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RN082524 AP04147 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1141038 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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