Provider Demographics
NPI:1598062465
Name:FIELDS, LORI S (CFM)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:S
Last Name:FIELDS
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 GARRETT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3430
Mailing Address - Country:US
Mailing Address - Phone:919-489-7408
Mailing Address - Fax:
Practice Address - Street 1:4228 GARRETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3430
Practice Address - Country:US
Practice Address - Phone:919-489-7408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier