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Individual

LORI HUSKINS BALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD1572
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1119050001
MEDICARE PALMETTO GOVERNM
TN
01
2240040
UNITED HEALTH CARE
TN
01
3036748
BLUE CROSS BLUE SHIELD
TN
01
6985019
CIGNA
TN
Enumeration date
06/15/2006
Last updated
03/14/2012
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