Provider Demographics
NPI:1336140227
Name:DUROCHER, LORI A (WHNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:DUROCHER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 29TH ST S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5315
Mailing Address - Country:US
Mailing Address - Phone:406-761-7924
Mailing Address - Fax:406-761-7945
Practice Address - Street 1:1400 29TH ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5316
Practice Address - Country:US
Practice Address - Phone:406-761-7924
Practice Address - Fax:406-761-7945
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN015771363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0433108Medicaid
MT0433108Medicaid
R11224Medicare UPIN