Healthcare Provider Details

I. General information

NPI: 1720917073
Provider Name (Legal Business Name): LORI ELIZABETH STEIN CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18881 W DODGE RD STE 300W
ELKHORN NE
68022-4648
US

IV. Provider business mailing address

684 GRAVEYARD KNOB RD
CALLAWAY VA
24067-4312
US

V. Phone/Fax

Practice location:
  • Phone: 757-409-4183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number0136000703
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: