Provider Demographics
NPI:1245850270
Name:SHOTTS, LORI MICHELE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:MICHELE
Last Name:SHOTTS
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 1:110 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-1658
Mailing Address - Country:US
Mailing Address - Phone:412-680-8250
Mailing Address - Fax:724-389-6734
Practice Address - Street 1:110 HOLMES ST
Practice Address - Street 2:
Practice Address - City:VANDERGRIFT
Practice Address - State:PA
Practice Address - Zip Code:15690-1658
Practice Address - Country:US
Practice Address - Phone:412-680-8250
Practice Address - Fax:724-389-6734
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021798363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology