Provider Demographics
NPI:1760890529
Name:CAMPOS, LORI ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:OCHOA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN-BSN
Mailing Address - Street 1:80 FORT BROWN SPH BLDG. S 1.330
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-755-0653
Mailing Address - Fax:956-983-7919
Practice Address - Street 1:80 FORT BROWN SPH BLDG. S 1.330
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-755-0653
Practice Address - Fax:956-983-7919
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX382650YNC5Medicare UPIN