Provider Demographics
NPI:1881080356
Name:CARLOUGH, LORI ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:CARLOUGH
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 1:2821 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4106
Mailing Address - Country:US
Mailing Address - Phone:972-672-5606
Mailing Address - Fax:
Practice Address - Street 1:2821 CASCADE DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4106
Practice Address - Country:US
Practice Address - Phone:972-672-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-12
Last Update Date:2015-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX564932163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant