Provider Demographics
NPI:1447756184
Name:PUMFORD, LORI ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:PUMFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HOTCHKISS ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-1748
Mailing Address - Country:US
Mailing Address - Phone:716-397-0969
Mailing Address - Fax:
Practice Address - Street 1:166 HOTCHKISS ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-1748
Practice Address - Country:US
Practice Address - Phone:716-397-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702305163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse