1306874052 NPI number — LORI JILL ELMORE MSN, CPNP-PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306874052 NPI number — LORI JILL ELMORE MSN, CPNP-PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELMORE
Provider First Name:
LORI
Provider Middle Name:
JILL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, CPNP-PC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GETTELFINGER
Provider Other First Name:
LORI
Provider Other Middle Name:
JILL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306874052
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6350 W A J HWY
Provider Second Line Business Mailing Address:
DEPARTMENT 100
Provider Business Mailing Address City Name:
TALBOTT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37877-8605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-355-3565
Provider Business Mailing Address Fax Number:
423-714-2355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 E WATT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALCOA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37701-2236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-273-1616
Provider Business Practice Location Address Fax Number:
865-273-1645
Provider Enumeration Date:
06/30/2006

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:  APN 0000006762 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000942 . This is a "CERTIFICATE OF FITNESS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: RN0000093981 . This is a "RN LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: TN0104 . This is a "JOHN DEERE ID #" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: APN000006762 . This is a "ADVANCE PRACTICE NURSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com