Provider Demographics
NPI:1437497989
Name:LOPEZ, LORI A (LPN)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:237 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411-1327
Mailing Address - Country:US
Mailing Address - Phone:585-500-9158
Mailing Address - Fax:
Practice Address - Street 1:237 W PARK ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-1327
Practice Address - Country:US
Practice Address - Phone:585-500-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306808-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse