Provider Demographics
NPI:1710334651
Name:MCENANEY-PREBLE, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MCENANEY-PREBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 QUIVAS ST
Mailing Address - Street 2:2ND FLOOR MC 1701
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4916
Mailing Address - Country:US
Mailing Address - Phone:303-602-8986
Mailing Address - Fax:
Practice Address - Street 1:500 QUIVAS ST
Practice Address - Street 2:2ND FLOOR MC 1701
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4916
Practice Address - Country:US
Practice Address - Phone:303-602-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN00181795163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse