Provider Demographics
NPI:1437416120
Name:WARREN, LORI ANN (APRN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:WARREN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:LUNDEEN BITTERMAN HOLLADAYWILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:470 MALABAR RD SE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3124
Mailing Address - Country:US
Mailing Address - Phone:321-733-2966
Mailing Address - Fax:321-586-4394
Practice Address - Street 1:775 E MERRITT ISLAND CSWY STE 115
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3311
Practice Address - Country:US
Practice Address - Phone:321-349-0642
Practice Address - Fax:321-349-0643
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9185417363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1437416120OtherNPI