Provider Demographics
NPI:1477621365
Name:MYERS, LORI LEE (APRN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LEE
Last Name:MYERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 LAFAYETTE RD
Mailing Address - Street 2:#9
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5430
Mailing Address - Country:US
Mailing Address - Phone:603-433-4774
Mailing Address - Fax:
Practice Address - Street 1:264 LAFAYETTE RD
Practice Address - Street 2:#9
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5430
Practice Address - Country:US
Practice Address - Phone:603-433-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH033925-23163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30342206Medicaid
NH3082913Medicaid
S94164Medicare UPIN
NH3082913Medicaid
NHNP211002Medicare PIN
NHNP2110Medicare PIN