Healthcare Provider Details

I. General information

NPI: 1194384834
Provider Name (Legal Business Name): LORNA FORBES NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WILLIAM ST
AUBURN NY
13021-3894
US

IV. Provider business mailing address

8417 HOBNAIL RD
MANLIUS NY
13104-9332
US

V. Phone/Fax

Practice location:
  • Phone: 315-751-7127
  • Fax: 315-748-5377
Mailing address:
  • Phone: 315-420-1546
  • Fax: 315-315-7485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LORNA CORDELLA FORBES
Title or Position: OWNER
Credential: NP
Phone: 315-751-7127