Provider Demographics
NPI:1952654493
Name:DORE, LORI (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35511 COUNTY ROAD 134
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:MT
Mailing Address - Zip Code:59221-9465
Mailing Address - Country:US
Mailing Address - Phone:406-742-5201
Mailing Address - Fax:406-742-3523
Practice Address - Street 1:35511 COUNTY ROAD 134
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MT
Practice Address - Zip Code:59221-9465
Practice Address - Country:US
Practice Address - Phone:406-742-5201
Practice Address - Fax:406-742-3523
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN13436163W00000X
NDRN72765163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse