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General NPI Number Information
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NPI Number | 1457124265
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Entity Type | Individual
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Provider Name | LORA ANN DIMICHELE AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 23333 HARVARD RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-6232
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660
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City | MENTOR
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State | OH
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Zip | 44061-0660
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Country | US
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Telephone | 440-516-3776
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Fax | 440-516-3783
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.0035361
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License Number State | OH
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