Individual
LORA FATHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.N, N.P-C
Contact information
Practice address
2326 18TH ST STE 210, COLUMBUS, IN 47201-5362
(812) 372-8680
(812) 372-9265
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71000213A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000213A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100342760B
—
IN
01
—
500030853
RR MEDICARE
IN
01
—
ANTHEM
000000317541
IN
01
—
CARESOURCE
820564758100
IN
01
—
SIHO
003707
IN
Enumeration date
03/07/2006
Last updated
04/29/2025
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