Provider Demographics
NPI:1043832041
Name:KELLEY NORTON, LORIE ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:ANN
Last Name:KELLEY NORTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21331
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97307-1331
Mailing Address - Country:US
Mailing Address - Phone:308-520-0143
Mailing Address - Fax:
Practice Address - Street 1:930 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:NE
Practice Address - Zip Code:68649-3511
Practice Address - Country:US
Practice Address - Phone:308-520-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202204512NP-PP363LF0000X
OR202204512NPPP363LF0000X
NEPENDING363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily