Healthcare Provider Details

I. General information

NPI: 1083349633
Provider Name (Legal Business Name): LORI ANNE CLINE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI ANNE ESMILLER

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CENTENNIAL DR STE 100
PEABODY MA
01960-7951
US

IV. Provider business mailing address

PO BOX 1224
DOVER NH
03821-1224
US

V. Phone/Fax

Practice location:
  • Phone: 879-232-0332
  • Fax:
Mailing address:
  • Phone: 207-939-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP221398
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNHL12043865
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10026693
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: