Provider Demographics
NPI:1407049745
Name:LOHR, NOELLE SUZANNE (ANP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:SUZANNE
Last Name:LOHR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1719
Mailing Address - Country:US
Mailing Address - Phone:716-404-2530
Mailing Address - Fax:
Practice Address - Street 1:710 SENECA ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1719
Practice Address - Country:US
Practice Address - Phone:716-404-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304712363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health