Provider Demographics
NPI:1003611880
Name:LEMOINE, LORA MAKENNA (LPN)
Entity type:Individual
Prefix:MRS
First Name:LORA
Middle Name:MAKENNA
Last Name:LEMOINE
Suffix:
Gender:
Credentials:LPN
Other - Prefix:MS
Other - First Name:LORA
Other - Middle Name:MAKENNA
Other - Last Name:LUTTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7845 N 68TH WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SPERRY
Mailing Address - State:OK
Mailing Address - Zip Code:74073-4893
Mailing Address - Country:US
Mailing Address - Phone:918-697-6604
Mailing Address - Fax:
Practice Address - Street 1:4111 S DARLINGTON AVE STE 1180
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6381
Practice Address - Country:US
Practice Address - Phone:918-697-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK220927164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse