Provider Demographics
NPI:1932106283
Name:BORRELL, LORRAINE ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:ANNE
Last Name:BORRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SANRUE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3642
Mailing Address - Country:US
Mailing Address - Phone:814-467-1517
Mailing Address - Fax:814-467-9977
Practice Address - Street 1:700 5TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1313
Practice Address - Country:US
Practice Address - Phone:814-467-9999
Practice Address - Fax:814-467-9977
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA086167Medicaid
PAQ30433Medicare UPIN
PA086167Medicaid