Provider Demographics
NPI:1285027136
Name:LOR, KAO A (NP-C)
Entity Type:Individual
Prefix:
First Name:KAO
Middle Name:A
Last Name:LOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 HOFFMAN RD STE B
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6557
Mailing Address - Country:US
Mailing Address - Phone:704-861-8669
Mailing Address - Fax:704-865-5081
Practice Address - Street 1:1895 HOFFMAN RD STE B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6557
Practice Address - Country:US
Practice Address - Phone:704-861-8669
Practice Address - Fax:704-865-5081
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC230704363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner