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General NPI Number Information
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NPI Number | 1295247187
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Entity Type | Individual
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Provider Name | LORI GWINN RN
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Gender | Female
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 205 E CLAY AVE
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City | PLATTSBURG
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State | MO
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Zip | 64477-8100
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Country | US
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Telephone | 816-539-2128
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Fax | 816-539-2128
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Provider Business Mailing Address
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Address Line | 19902 MURPHY RD
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City | TRIMBLE
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State | MO
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Zip | 64492-9183
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Country | US
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Telephone | 816-592-0520
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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 | 139200
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License Number State | MO
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