Provider Demographics
NPI:1629063763
Name:FIELDS, LORI A (APRN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:FIELDS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:SAWYER OR FIELDS ABD HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:6908 COLTON RD
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8468
Mailing Address - Country:US
Mailing Address - Phone:502-296-0768
Mailing Address - Fax:502-429-6157
Practice Address - Street 1:945 W RUSSELL ST
Practice Address - Street 2:
Practice Address - City:ELKHORN CITY
Practice Address - State:KY
Practice Address - Zip Code:41522-9032
Practice Address - Country:US
Practice Address - Phone:800-226-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002571363L00000X, 363LF0000X, 363LF0000X
IN28139072A163W00000X
IN1000604A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100264630Medicaid
KY3002571OtherKY APRN LICENSE
KYP00783049OtherRAILROAD MECICARE / NICC
KY000000620290OtherANTHEM NHC
KY105644OtherSIHO NHC
KY3002571OtherKY APRN LICENSE
KYP00783049OtherRAILROAD MECICARE / NICC
KY000000620290OtherANTHEM NHC