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General NPI Number Information
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NPI Number | 1235507377
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Entity Type | Individual
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Provider Name | LORI JEAN WAIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2015
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 107 MOUNT NEBO POINTE RD STE 101
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City | PITTSBURGH
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State | PA
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Zip | 15237-1316
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Country | US
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Telephone | 412-548-1090
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Fax | 412-548-3123
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Provider Business Mailing Address
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Address Line | 107 MOUNT NEBO PTE STE 101
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City | PITTSBURGH
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State | PA
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Zip | 15237-1316
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Country | US
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Telephone | 412-548-1090
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Fax | 125-483-1234
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015293
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License Number State | PA
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