Provider Demographics
NPI:1033935341
Name:EDMONDSON, LORI (RN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:EDMONDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 WELLINGSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-5146
Mailing Address - Country:US
Mailing Address - Phone:216-288-2699
Mailing Address - Fax:
Practice Address - Street 1:1214 WELLINGSHIRE CIR
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-5146
Practice Address - Country:US
Practice Address - Phone:216-288-2699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No332U00000XSuppliersHome Delivered Meals
No172A00000XOther Service ProvidersDriver