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General NPI Number Information
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NPI Number | 1225232952
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Entity Type | Individual
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Provider Name | LORI FAUQUIER
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 11672 LITTLE RIVER WAY
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City | PARRISH
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State | FL
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Zip | 34219-3233
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Country | US
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Telephone | 845-464-4051
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Fax |
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Provider Business Mailing Address
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Address Line | 1672 LITTLE RIVER WAY
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City | PARRISH
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State | FL
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Zip | 34219
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Country | US
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Telephone | 941-732-3324
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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 | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | 26NN8867700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F420560
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License Number State | NY
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