Provider Demographics
NPI:1326155862
Name:REISER, LORRAINE M (CRNP)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:M
Last Name:REISER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CLIMAX ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-1347
Mailing Address - Country:US
Mailing Address - Phone:412-431-3520
Mailing Address - Fax:412-431-3525
Practice Address - Street 1:317 CLIMAX ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-1347
Practice Address - Country:US
Practice Address - Phone:412-431-3520
Practice Address - Fax:412-431-3525
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004306W363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016985070002Medicaid
PATP004306WOtherLICENSE