Provider Demographics
NPI:1629487996
Name:PELTIER, LORI R (APRN)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:R
Last Name:PELTIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4333
Mailing Address - Country:US
Mailing Address - Phone:785-273-8224
Mailing Address - Fax:785-273-8412
Practice Address - Street 1:4100 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4333
Practice Address - Country:US
Practice Address - Phone:785-273-8224
Practice Address - Fax:785-273-8412
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77235363L00000X, 363L00000X
KS53-77235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily