Provider Demographics
NPI:1811205578
Name:KORALEWSKI, LORI ANN (LPN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:KORALEWSKI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:9517 HULDA DR
Mailing Address - Street 2:
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-2648
Mailing Address - Country:US
Mailing Address - Phone:262-412-8122
Mailing Address - Fax:
Practice Address - Street 1:9517 HULDA DR
Practice Address - Street 2:
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177-2648
Practice Address - Country:US
Practice Address - Phone:262-412-8122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27610-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse