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Individual

LORI LAFAYETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
220 MULBERRY ST STE A, WAPELLO, IA 52653-1570
(319) 768-4090
Mailing address
220 MULBERRY ST STE A, WAPELLO, IA 52653-1570
(319) 768-4090

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
163849
RH MEDICARE
IA
01
233233
MIDLANDS CHOICE
IA
01
40889
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
07/28/2006
Last updated
01/12/2016
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