Provider Demographics
NPI:1700965712
Name:ERISON, LORRAINE L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:L
Last Name:ERISON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8526 BEACON HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-5847
Mailing Address - Country:US
Mailing Address - Phone:440-543-4325
Mailing Address - Fax:
Practice Address - Street 1:8526 BEACON HILL DR
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-5847
Practice Address - Country:US
Practice Address - Phone:440-543-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN . 124119363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP42440Medicare UPIN
OHNP08981Medicare PIN