Provider Demographics
NPI:1497964167
Name:HULL-GROMMESH, LORI DENISE (RN MSN CCRN ACNP-BC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:DENISE
Last Name:HULL-GROMMESH
Suffix:
Gender:F
Credentials:RN MSN CCRN ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 E STAR CT
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6702
Mailing Address - Country:US
Mailing Address - Phone:970-252-1020
Mailing Address - Fax:970-252-1041
Practice Address - Street 1:630 E STAR CT
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-6702
Practice Address - Country:US
Practice Address - Phone:970-252-1020
Practice Address - Fax:970-252-1041
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX656611363LA2100X
COC-APN.0004052-C-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care