Healthcare Provider Details

I. General information

NPI: 1235507377
Provider Name (Legal Business Name): LORI JEAN WAIN DNP, MSNED, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI JEAN BRYANT DNP, MSNED, FNP-C

II. Dates (important events)

Enumeration Date: 09/06/2015
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 BROOKTREE CT STE 340
WEXFORD PA
15090-9271
US

IV. Provider business mailing address

6400 BROOKTREE CT STE 340
WEXFORD PA
15090-9271
US

V. Phone/Fax

Practice location:
  • Phone: 724-719-2219
  • Fax: 724-670-3435
Mailing address:
  • Phone: 724-719-2219
  • Fax: 724-670-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015293
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: