Individual
LORI HEALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28180166A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000854176
ANTHEM PROVIDER NUMBER
IN
05
—
201209540
—
IN
Enumeration date
12/20/2013
Last updated
11/18/2014
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