Provider Demographics
NPI:1275033003
Name:HUNTSINGER, LORI ANN (APN)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:HUNTSINGER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:BOFINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2500 MORRIS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5675
Mailing Address - Country:US
Mailing Address - Phone:732-906-9600
Mailing Address - Fax:
Practice Address - Street 1:15000 MIDLANTIC DR STE 102
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1573
Practice Address - Country:US
Practice Address - Phone:856-255-5479
Practice Address - Fax:833-606-0165
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00771300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner