Healthcare Provider Details

I. General information

NPI: 1730164344
Provider Name (Legal Business Name): LORI WELLS STROUD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S CENTRAL AVE
PINK HILL NC
28572-8084
US

IV. Provider business mailing address

701 DOCTORS DR SUITE N
KINSTON NC
28501-1584
US

V. Phone/Fax

Practice location:
  • Phone: 252-568-4111
  • Fax: 252-568-6396
Mailing address:
  • Phone: 252-559-2200
  • Fax: 252-522-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201435
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: