Provider Demographics
NPI:1659470482
Name:MARTIN-PLANK, LORRAINE (LORI) (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LORRAINE (LORI)
Middle Name:
Last Name:MARTIN-PLANK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 BLAIR MILL RD
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2223
Mailing Address - Country:US
Mailing Address - Phone:215-902-9014
Mailing Address - Fax:888-816-8109
Practice Address - Street 1:680 BLAIR MILL RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2223
Practice Address - Country:US
Practice Address - Phone:215-902-9014
Practice Address - Fax:888-816-8109
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001104B363LF0000X
NJ26NN09997600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA1593093OtherHIGHMARK BLUE SHIELD
PA2270869000OtherKEYSTONE EAST/KEYSTONE 65
PAS84186Medicare UPIN
PA30027026OtherKEYSTONE MERCY HEALTH PLA
PA36116VP001104BOtherHEALTH PARTNERS
PA1009851800001Medicaid
PA1593093OtherPERSONAL/BLUE CHOICE