Individual
LORI T ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, BELLIN MEMORIAL HOSPITAL INC, GREEN BAY, WI 54301-3505
(920) 431-5582
(920) 433-7450
Mailing address
PO BOX 23400, GREEN BAY, WI 54305-3400
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
5142-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74004359
—
KY
Enumeration date
10/06/2006
Last updated
07/14/2015
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