# LORI BANNON P LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013794288
- **Authorized official:** LORI BANNON AGNP-C, PMHNP-C (OWNER)
- **Authorized official phone:** (577) 540-5537

## Contact information

- **Practice address:** 4509 WHITECHAPEL DR, VIRGINIA BEACH, VA 23455-6447
- **Practice address phone:** (757) 460-4655
- **Practice address fax:** (757) 460-7744
- **Mailing address:** 4509 WHITECHAPEL DR, VIRGINIA BEACH, VA 23455-6447
- **Mailing address phone:** (757) 460-4655
- **Mailing address fax:** (757) 460-7744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2023
- **Last updated:** 09/12/2023