1568902203 NPI number — LORNA M PICHE APRN

Table of content: LORNA M PICHE APRN (NPI 1568902203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568902203 NPI number — LORNA M PICHE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PICHE
Provider First Name:
LORNA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELLIOTT
Provider Other First Name:
LORNA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LORNA AVERY: APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568902203
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LACONIA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03247-1327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-527-2977
Provider Business Mailing Address Fax Number:
603-527-2887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
724 NORTH MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LACONIA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03246-2742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-652-2792
Provider Business Practice Location Address Fax Number:
603-527-2770
Provider Enumeration Date:
02/28/2017

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: 363L00000X , with the licence number:  036164-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 036164-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LG0600X , with the licence number: 036164-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2016029815 . This is a "NURSE PRACTIONER CERTIFICATION" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 036164-23 . This is a "NURSE PRACTIONER" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".