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General NPI Number Information
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NPI Number | 1073107181
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Entity Type | Individual
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Provider Name | LORRIE HALLMARK RN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 800 PRUDENTIAL DR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8202
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Country | US
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Telephone | 904-202-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 27950 OLD MILLER RD
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City | ARDMORE
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State | AL
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Zip | 35739-7654
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Country | US
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Telephone | 256-431-7955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-39580
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License Number State | AL
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