Provider Demographics
NPI:1720149040
Name:MCGUIRE, LORI (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 S 400 E
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3700
Mailing Address - Country:US
Mailing Address - Phone:435-673-3528
Mailing Address - Fax:435-628-6425
Practice Address - Street 1:620 S 400 E
Practice Address - Street 2:SUITE 400
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3700
Practice Address - Country:US
Practice Address - Phone:435-673-3528
Practice Address - Fax:435-628-6425
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8652022-3102163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7109218Medicaid