# LORI LYN ENLOW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700875598
- **Gender:** F
- **Credential:** NURSE PRACTITIONER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | R0067005 | OK | Yes |

## Other

- **Enumeration date:** 10/14/2005
- **Last updated:** 06/04/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200000030A | MEDICAID GROUP NUMBER | OK |
| 05 | — | 200073760A | — | OK |
| 01 | — | 400522239 | MEDICARE GROUP PTAN | OK |
| 01 | — | DA5295 | RAILROAD MEDICARE GROUP NUMBER | OK |
| 01 | — | P00399872 | RAILROAD MEDICARE PIN NUMBER | OK |