Provider Demographics
NPI:1134917222
Name:NYLUND, LORA DIANE (MSN, APRN)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:DIANE
Last Name:NYLUND
Suffix:
Gender:X
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28744 STORMCLOUD PASS
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6424
Mailing Address - Country:US
Mailing Address - Phone:901-254-9844
Mailing Address - Fax:
Practice Address - Street 1:3520 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-1448
Practice Address - Country:US
Practice Address - Phone:727-471-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038011363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology