Provider Demographics
NPI:1629603519
Name:VOGT, LORINE (CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:LORINE
Middle Name:
Last Name:VOGT
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 CHESTER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1039
Practice Address - Country:US
Practice Address - Phone:856-341-8474
Practice Address - Fax:856-325-5003
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104606269363L00000X
PACNM06261367A00000X
NJ25ME00072501367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN692771OtherRN LICENSE