Provider Demographics
NPI:1730355132
Name:HARRISON, LORI REPP (FNP)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:REPP
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:RENEE
Other - Last Name:REPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 W THARPE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-5300
Mailing Address - Country:US
Mailing Address - Phone:850-274-4238
Mailing Address - Fax:850-487-3553
Practice Address - Street 1:1000 W THARPE ST STE 5
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5300
Practice Address - Country:US
Practice Address - Phone:850-274-4238
Practice Address - Fax:850-487-3553
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9220859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily