Provider Demographics
NPI:1144004110
Name:PRICE, LORA LYNN
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:LYNN
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CROSSRAILS LN
Mailing Address - Street 2:
Mailing Address - City:COOL RIDGE
Mailing Address - State:WV
Mailing Address - Zip Code:25825-7746
Mailing Address - Country:US
Mailing Address - Phone:252-216-9699
Mailing Address - Fax:
Practice Address - Street 1:122 CROSSRAILS LN
Practice Address - Street 2:
Practice Address - City:COOL RIDGE
Practice Address - State:WV
Practice Address - Zip Code:25825-7746
Practice Address - Country:US
Practice Address - Phone:252-216-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant