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Individual

MS. LORI L HOCKENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5734 COVENTRY LANE, FORT WAYNE, IN 46804-7141
(260) 436-7875
(260) 432-9812
Mailing address
121 W HIGH ST, 5TH FLOOR, LIMA, OH 45801-4340
(419) 998-4573
(419) 998-4586

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28100297
IN
367500000X
Certified Registered Nurse Anesthetist
RN226280
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000209221
ANTHEM BC/BS
OH
05
2191686
OH
01
34195975700
WORKMENS COMPENSATION
OH
01
3419597570004
MEDICAL MUTUAL OF OHIO
OH
01
430065384
MEDICARE RAILROAD
OH
Enumeration date
09/01/2005
Last updated
02/04/2016
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