Healthcare Provider Details

I. General information

NPI: 1326416447
Provider Name (Legal Business Name): LORI HOAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2015
Last Update Date: 09/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BROAD ST
JOHNSTOWN PA
15906-2716
US

IV. Provider business mailing address

2726 WILLIAM PENN AVE
JOHNSTOWN PA
15909-1031
US

V. Phone/Fax

Practice location:
  • Phone: 814-535-6000
  • Fax:
Mailing address:
  • Phone: 724-994-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN551921
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: