Provider Demographics
NPI:1740548320
Name:JUAREZ, LORI LYNNE (MSN, APRN, BC, FNP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:LYNNE
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MSN, APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 W MEETING ST BLDG 5H
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6233
Mailing Address - Country:US
Mailing Address - Phone:803-285-2273
Mailing Address - Fax:803-286-0599
Practice Address - Street 1:838 W MEETING ST BLDG 5H
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6233
Practice Address - Country:US
Practice Address - Phone:803-285-2273
Practice Address - Fax:803-286-0599
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily