Provider Demographics
NPI:1699564179
Name:FLETCHER, LORI ANN
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:FLETCHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3735
Mailing Address - Country:US
Mailing Address - Phone:301-818-1632
Mailing Address - Fax:
Practice Address - Street 1:3615 HARDING AVE STE 509
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3757
Practice Address - Country:US
Practice Address - Phone:808-739-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program