Provider Demographics
NPI:1629466792
Name:LORING, KELLY DAVEY (MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:DAVEY
Last Name:LORING
Suffix:
Gender:F
Credentials:MSN-FNP
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Mailing Address - Street 1:110 S WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3546
Mailing Address - Country:US
Mailing Address - Phone:407-905-8827
Mailing Address - Fax:407-905-8998
Practice Address - Street 1:2140 N DON WICKHAM DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1923
Practice Address - Country:US
Practice Address - Phone:407-905-8827
Practice Address - Fax:407-660-1667
Is Sole Proprietor?:No
Enumeration Date:2014-12-24
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP17114363LF0000X
FLAPRN11004283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily