Provider Demographics
NPI:1538420245
Name:ROEVER, LORIE JEANNE (MSN)
Entity type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:JEANNE
Last Name:ROEVER
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:LORIE
Other - Middle Name:JEANNE
Other - Last Name:HUEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE STE 100
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:888-562-5442
Mailing Address - Fax:562-499-6171
Practice Address - Street 1:3000 CORPORATE EXCHANGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231
Practice Address - Country:US
Practice Address - Phone:888-562-5442
Practice Address - Fax:562-499-6171
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015276363LF0000X
IL209022033363LF0000X
OHRN.315474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily