Individual
LORRAINE DYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
526 W STATE ST, ROCKFORD, IL 61101-1214
(815) 968-9300
(812) 332-6090
Mailing address
4882 HUXLEY DR, ROCKFORD, IL 61101-9004
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043-079653
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18047
C.A.D.C
—
Enumeration date
01/30/2012
Last updated
01/30/2012
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