Individual
LORI ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
301 W AIRLINE HWY STE 201, LA PLACE, LA 70068-3823
(504) 517-2873
Mailing address
228 SPRUCE ST, LA PLACE, LA 70068-4700
(504) 517-2873
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
280026
LA
246RM2200X
Medical Laboratory Technician
Primary
—
—
331L00000X
Blood Bank
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5043194950
—
LA
Enumeration date
12/02/2020
Last updated
11/20/2021
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