Provider Demographics
NPI:1194834770
Name:CONNORS, LORELI LOUISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORELI
Middle Name:LOUISE
Last Name:CONNORS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 THURBER DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:NY
Mailing Address - Zip Code:13165-1600
Mailing Address - Country:US
Mailing Address - Phone:315-539-1980
Mailing Address - Fax:315-539-1054
Practice Address - Street 1:31 THURBER DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NY
Practice Address - Zip Code:13165-1600
Practice Address - Country:US
Practice Address - Phone:315-539-1980
Practice Address - Fax:315-539-1054
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY500750163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY500750Medicaid