Provider Demographics
NPI:1326911355
Name:PRESTON, LORI MARIE (LPN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:MARIE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:BLACKFOOT
Mailing Address - State:ID
Mailing Address - Zip Code:83221-1799
Mailing Address - Country:US
Mailing Address - Phone:208-643-9800
Mailing Address - Fax:208-785-9415
Practice Address - Street 1:98 POPLAR ST
Practice Address - Street 2:
Practice Address - City:BLACKFOOT
Practice Address - State:ID
Practice Address - Zip Code:83221-1799
Practice Address - Country:US
Practice Address - Phone:208-643-9800
Practice Address - Fax:208-785-9415
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPN7827164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse