Healthcare Provider Details

I. General information

NPI: 1306809322
Provider Name (Legal Business Name): LORI THOMPSON WRIGHT NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BELLEVIEW AVE SE
ROANOKE VA
24014-1838
US

IV. Provider business mailing address

5057 BETHLEHEM RD
BOONES MILL VA
24065-3543
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7796
  • Fax:
Mailing address:
  • Phone: 540-597-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0024166321
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number0001155896
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: