Provider Demographics
NPI:1801340823
Name:BAER, LORNA (FNP)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:
Last Name:BAER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14894 BLUE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8771
Mailing Address - Country:US
Mailing Address - Phone:801-718-2829
Mailing Address - Fax:
Practice Address - Street 1:14894 BLUE BAY CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8771
Practice Address - Country:US
Practice Address - Phone:801-718-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT320469-4408363L00000X
FL11019894363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner