Provider Demographics
NPI:1437651106
Name:ASHLEY, LORI CRAIG (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:CRAIG
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ADELLE
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98586-0026
Mailing Address - Country:US
Mailing Address - Phone:360-875-9343
Mailing Address - Fax:360-875-9323
Practice Address - Street 1:1216 W ROBERT BUSH DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98586
Practice Address - Country:US
Practice Address - Phone:360-875-9343
Practice Address - Fax:260-875-9323
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00095705163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse