Provider Demographics
NPI:1558650358
Name:RAIHL, LORI (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:RAIHL
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 1:18945 FM 2252
Mailing Address - Street 2:SUITE 115
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2562
Mailing Address - Country:US
Mailing Address - Phone:210-651-0027
Mailing Address - Fax:210-651-0029
Practice Address - Street 1:NAVY HOSPITAL PENSACOLA
Practice Address - Street 2:6000 W. HWY 98
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9310823163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse