Provider Demographics
NPI:1437559390
Name:HARRIS, LORI K (CRNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E BRADY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4648
Mailing Address - Country:US
Mailing Address - Phone:724-282-1627
Mailing Address - Fax:724-282-4810
Practice Address - Street 1:901 E BRADY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4648
Practice Address - Country:US
Practice Address - Phone:724-282-1627
Practice Address - Fax:724-282-4810
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014061363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health