Provider Demographics
NPI:1649252537
Name:LOHRMANN, MARY DUCEY (PA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:DUCEY
Last Name:LOHRMANN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746081
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6081
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:4380 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2932
Practice Address - Country:US
Practice Address - Phone:719-454-6010
Practice Address - Fax:719-258-1321
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL086001738363AM0700X
COPA.0007276363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN550894537OtherTAX ID
IN550894537OtherTAX ID
ILR61771Medicare UPIN