Provider Demographics
NPI:1487892881
Name:SUGGS, LORI DEANNA
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:DEANNA
Last Name:SUGGS
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 1:1925 SAINT PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-5239
Mailing Address - Country:US
Mailing Address - Phone:910-728-5019
Mailing Address - Fax:
Practice Address - Street 1:1925 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-5239
Practice Address - Country:US
Practice Address - Phone:910-728-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71677164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse