Provider Demographics
NPI:1568509776
Name:SPRINGSTON, LORI
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:SPRINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4912 FAIRLAND RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3914
Mailing Address - Country:US
Mailing Address - Phone:330-825-9514
Mailing Address - Fax:
Practice Address - Street 1:4912 FAIRLAND RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3914
Practice Address - Country:US
Practice Address - Phone:330-825-9514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2349060374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide