Provider Demographics
NPI:1114065398
Name:JAMES, LORI SHALANE (NP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:SHALANE
Last Name:JAMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:931-388-8802
Mailing Address - Fax:931-490-2292
Practice Address - Street 1:1040 N JAMES CAMPBELL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2756
Practice Address - Country:US
Practice Address - Phone:931-388-8802
Practice Address - Fax:931-490-2292
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7903363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4156856OtherBCBST
TNP01014353OtherRR MEDICARE
TN1507670Medicaid
TN3710089Medicaid
TN4315456OtherBLUE CROSS-BLUE SHIELD
TN39292091Medicaid
TNP01014353OtherRR MEDICARE
TNCE0561Medicare PIN
TN4315456OtherBLUE CROSS-BLUE SHIELD
TN1507670Medicaid
TN1035I01814Medicare PIN
TN39292091Medicare PIN