Healthcare Provider Details

I. General information

NPI: 1134201684
Provider Name (Legal Business Name): LORI LERAE AGUIRRE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

6832 MAIN ST UNIT 232
WILMINGTON NC
28405-8342
US

V. Phone/Fax

Practice location:
  • Phone: 910-667-4620
  • Fax: 910-667-4639
Mailing address:
  • Phone: 910-756-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5002013
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024167869
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: