Provider Demographics
NPI:1790889145
Name:ADELMANN, LORI A (ARNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:ADELMANN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TRILLIUM WAY
Mailing Address - Street 2:STE. 210
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-8949
Mailing Address - Country:US
Mailing Address - Phone:606-523-3038
Mailing Address - Fax:606-523-3039
Practice Address - Street 1:60 S STEWART RD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4675
Practice Address - Country:US
Practice Address - Phone:606-528-9770
Practice Address - Fax:606-528-9769
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3004336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78012648Medicaid
KY78012648Medicaid
Q24304Medicare UPIN