Provider Demographics
NPI:1538316443
Name:BYRD, LORRAINE L (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:L
Last Name:BYRD
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14417
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1417
Mailing Address - Country:US
Mailing Address - Phone:912-629-2290
Mailing Address - Fax:912-629-2291
Practice Address - Street 1:131 SILVERWOOD CT
Practice Address - Street 2:SUITE 100
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5131
Practice Address - Country:US
Practice Address - Phone:912-826-3927
Practice Address - Fax:912-826-3931
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165617363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003124134CMedicaid
GA202I504201Medicare PIN