Provider Demographics
NPI:1346906526
Name:STANLEY, LORI ANN (NP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:STANLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:MENSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:355 W 16TH ST STE 5100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2274
Mailing Address - Country:US
Mailing Address - Phone:317-963-1300
Mailing Address - Fax:317-222-2012
Practice Address - Street 1:355 W 16TH ST STE 5100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2274
Practice Address - Country:US
Practice Address - Phone:317-963-1300
Practice Address - Fax:317-222-2012
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28223358A163W00000X
IN71011867A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse