Healthcare Provider Details

I. General information

NPI: 1285605808
Provider Name (Legal Business Name): LORRI LYNN DAVISON A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N KANSAS AVE SUITE 100
HASTINGS NE
68901-4470
US

IV. Provider business mailing address

1242 N TURNER AVE
HASTINGS NE
68901-7669
US

V. Phone/Fax

Practice location:
  • Phone: 402-460-5899
  • Fax: 402-460-5619
Mailing address:
  • Phone: 402-463-7647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number110672
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: