Healthcare Provider Details

I. General information

NPI: 1285345603
Provider Name (Legal Business Name): LORI DOOLEN RN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 RICHARDS RD
LINCOLNVILLE ME
04849-5615
US

IV. Provider business mailing address

40 RICHARDS RD
LINCOLNVILLE ME
04849-5615
US

V. Phone/Fax

Practice location:
  • Phone: 207-323-5780
  • Fax:
Mailing address:
  • Phone: 207-323-5780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number48472
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: