Provider Demographics
NPI:1851369839
Name:TOMLINSON, LORA RICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:RICHELLE
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:RICHELLE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7141 RUSHING WATER CT
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-9091
Mailing Address - Country:US
Mailing Address - Phone:251-626-6642
Mailing Address - Fax:251-626-6642
Practice Address - Street 1:1000 W MORENO ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2316
Practice Address - Country:US
Practice Address - Phone:850-434-4814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9182771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily