Healthcare Provider Details

I. General information

NPI: 1083071476
Provider Name (Legal Business Name): LORAINE CIRA RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 01/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3504
US

IV. Provider business mailing address

4485 IRONWOOD LN IRONWOOD LANE
TERRE HAUTE IN
47802-8143
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2232
  • Fax:
Mailing address:
  • Phone: 303-880-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number245221
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: