Individual
LORENA KAY STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
810 N WELO ST, TIOGA, ND 58852-7157
(701) 664-3305
Mailing address
810 N WELO ST, TIOGA, ND 58852-7157
(701) 664-3305
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R37497
ND
363L00000X
Nurse Practitioner
99487
NC
363LF0000X
Family Nurse Practitioner
Primary
R37497
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881947695
UNKNOWN
—
05
—
1881947695
—
NC
Enumeration date
10/17/2012
Last updated
11/12/2018
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