Provider Demographics
NPI:1083943567
Name:PAIT, LORELL SNEEDEN (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LORELL
Middle Name:SNEEDEN
Last Name:PAIT
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:LORELL
Other - Middle Name:SNEEDEN
Other - Last Name:HARALDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-C
Mailing Address - Street 1:795 OCEAN HWY, WEST
Mailing Address - Street 2:
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462
Mailing Address - Country:US
Mailing Address - Phone:910-755-4087
Mailing Address - Fax:910-755-4088
Practice Address - Street 1:795 OCEAN HIGHWAY WEST
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462
Practice Address - Country:US
Practice Address - Phone:910-755-4087
Practice Address - Fax:910-755-4088
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily