Provider Demographics
NPI:1225042682
Name:CUMMINGS, LORI LANE (APRN CPNP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LANE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:APRN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 SHEPPARD ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3460
Mailing Address - Country:US
Mailing Address - Phone:318-377-7116
Mailing Address - Fax:318-377-9979
Practice Address - Street 1:1232 SHEPPARD ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3460
Practice Address - Country:US
Practice Address - Phone:318-377-7116
Practice Address - Fax:318-377-9979
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN082524 AP04147363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1141038Medicaid
P76526Medicare UPIN
LA4C534Medicare ID - Type Unspecified