Individual
LORI JEAN SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
300 MT CLEMENT PARK STE C, TAPPAHANNOCK, VA 22560-5098
(804) 443-6063
(804) 443-6005
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
0024184974
VA
363LF0000X
Family Nurse Practitioner
Primary
0024184974
VA
Other
Enumeration date
08/30/2022
Last updated
03/05/2024
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