Provider Demographics
NPI:1275599599
Name:JULIAN-TROTTER, LORRI A (FNP)
Entity Type:Individual
Prefix:
First Name:LORRI
Middle Name:A
Last Name:JULIAN-TROTTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LORRI
Other - Middle Name:A
Other - Last Name:TROTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-269-5712
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:10763 HWY 39
Practice Address - Street 2:STE. 200
Practice Address - City:MT. VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712-7823
Practice Address - Country:US
Practice Address - Phone:417-269-2460
Practice Address - Fax:416-269-2462
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO128702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO220435OtherANTHEM
33658031OtherBCBS
MO428384820Medicaid
33658031OtherBCBS
MO428384820Medicaid