Individual
LORI JO WINGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
4222 WENDOVER AVE, 400, ODESSA, TX 79762-5945
(432) 367-8080
(432) 366-8443
Mailing address
4222 WENDOVER AVE, 400, ODESSA, TX 79762-5945
(432) 367-8080
(432) 366-8443
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
236283
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
236283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236283
STATE LICENSE
TX
Enumeration date
06/13/2007
Last updated
03/17/2018
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