Provider Demographics
NPI:1760966501
Name:MAYFIELD, LORI (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E PLEASANT VIEW LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-2751
Mailing Address - Country:US
Mailing Address - Phone:435-669-4023
Mailing Address - Fax:
Practice Address - Street 1:1037 E 100 S
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3006
Practice Address - Country:US
Practice Address - Phone:435-662-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6127159-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily