Individual
LORI MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 337-8205
Mailing address
975 FISH HILL RD, COVENTRY, RI 02816-4715
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN10887
RI
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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