Provider Demographics
NPI:1396149142
Name:JERINA, LORI ANN (CNM)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:JERINA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:FREYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:969 E HIGHWAY 33
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-2547
Mailing Address - Country:US
Mailing Address - Phone:402-826-3222
Mailing Address - Fax:
Practice Address - Street 1:969 E HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-2547
Practice Address - Country:US
Practice Address - Phone:402-826-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120063367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife