Individual
MS. LORI DILLARD FUQUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
790 HILL LN, BRACEY, VA 23919-2174
(919) 995-5421
(903) 213-9122
Mailing address
790 HILL LN, BRACEY, VA 23919-2174
(919) 995-5421
(903) 213-9122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
131861
NC
363L00000X
Nurse Practitioner
AP120850
TX
363LF0000X
Family Nurse Practitioner
Primary
0024190402
VA
363LF0000X
Family Nurse Practitioner
811726
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1X7132
MEDICARE
TX
Enumeration date
02/17/2007
Last updated
01/01/2025
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