Provider Demographics
NPI:1295920213
Name:CROKER, LOREEN R
Entity type:Individual
Prefix:
First Name:LOREEN
Middle Name:R
Last Name:CROKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 SANDRA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408
Mailing Address - Country:US
Mailing Address - Phone:802-338-0150
Mailing Address - Fax:
Practice Address - Street 1:233 SANDRA CIRCLE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408
Practice Address - Country:US
Practice Address - Phone:802-338-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist