Healthcare Provider Details

I. General information

NPI: 1558176859
Provider Name (Legal Business Name): LORI ELIZABETH WEST RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 KEMPSVILLE RD
NORFOLK VA
23502-3920
US

IV. Provider business mailing address

1113 GAYMONT CT
VIRGINIA BEACH VA
23456-6872
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-6068
  • Fax:
Mailing address:
  • Phone: 757-647-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0001143311
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number0001143311
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0001143311
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001143311
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: