Provider Demographics
NPI:1801922083
Name:BYERS, LORA LEA (LPN)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:LEA
Last Name:BYERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BRINDLEY ST
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-1731
Mailing Address - Country:US
Mailing Address - Phone:608-485-1024
Mailing Address - Fax:
Practice Address - Street 1:203 BRINDLEY ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1731
Practice Address - Country:US
Practice Address - Phone:608-485-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164W00000X164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse