Provider Demographics
NPI:1982984555
Name:PASSEY, LORI E (DNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:E
Last Name:PASSEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5171 COTTONWOOD ST
Mailing Address - Street 2:SUITE 950
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5704
Mailing Address - Country:US
Mailing Address - Phone:801-507-9555
Mailing Address - Fax:801-507-9550
Practice Address - Street 1:5171 COTTONWOOD ST
Practice Address - Street 2:SUITE 950
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5704
Practice Address - Country:US
Practice Address - Phone:801-507-9555
Practice Address - Fax:801-507-9550
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3303534405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care