Healthcare Provider Details

I. General information

NPI: 1700371440
Provider Name (Legal Business Name): LORI K GOLA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI K GROVE

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N POINTE BLVD
LANCASTER PA
17601-4132
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-0700
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019002
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN561782
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: