Provider Demographics
NPI:1942679139
Name:OLLBERDING, LORI (FNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:OLLBERDING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 SAUNDERSVILLE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-8940
Mailing Address - Country:US
Mailing Address - Phone:615-442-3517
Mailing Address - Fax:855-540-4722
Practice Address - Street 1:4355 FERGUSON DR STE 270
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-5137
Practice Address - Country:US
Practice Address - Phone:513-718-0115
Practice Address - Fax:513-718-0116
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17981-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily