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General NPI Number Information
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NPI Number | 1336111673
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Entity Type | Individual
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Provider Name | LORIE MICHELLE WARDLOW APRN
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 1573 KY HIGHWAY 259 N
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City | BROWNSVILLE
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State | KY
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Zip | 42210-9206
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Country | US
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Telephone | 270-597-2168
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Fax | 270-597-2168
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Provider Business Mailing Address
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Address Line | 427 US 31W BYP
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1703
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Country | US
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Telephone | 270-796-8000
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Fax | 270-796-8000
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4434P
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License Number State | KY
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