Provider Demographics
NPI:1407250251
Name:LORI J. WESSON, ARNP, INC.
Entity Type:Organization
Organization Name:LORI J. WESSON, ARNP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WESSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:941-822-5117
Mailing Address - Street 1:1807 MANASOTA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-6462
Mailing Address - Country:US
Mailing Address - Phone:941-822-5117
Mailing Address - Fax:941-312-5436
Practice Address - Street 1:1807 MANASOTA BEACH RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-6462
Practice Address - Country:US
Practice Address - Phone:941-822-5117
Practice Address - Fax:941-312-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP21960723104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1699116442Medicare UPIN
FLHN955ZMedicare UPIN