Provider Demographics
NPI:1710041074
Name:VEROSTICK, LORI (PMHNP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:VEROSTICK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:TALLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:814-942-5000
Mailing Address - Fax:814-942-9500
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:814-942-5000
Practice Address - Fax:814-942-9500
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1370696OtherBC BS
PA0018799940005Medicaid
PAP48536Medicare UPIN
PA054162Medicare PIN