MEDICARE: LORI M. LIPARI FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704171699	MI

General Provider Information

NPI Number	:	1194060236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI M. LIPARI FNP-C

Provider Business Mailing Address
First Line	:	50521 34TH AVE
Second Line	:
City	:	BANGOR
State	:	MI
Zip	:	49013-9726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50521 34TH AVE
Second Line	:
City	:	BANGOR
State	:	MI
Zip	:	49013-9726
Country	:	US
Telephone Number	:	269-427-8339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	05/31/2026

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