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General NPI Number Information
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NPI Number | 1548014277
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Entity Type | Individual
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Provider Name | LORI MARIE DUKE APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 5904 SUMMERFIELD DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4306
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Country | US
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Telephone | 430-200-4350
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Fax |
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Provider Business Mailing Address
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Address Line | 18 OUIDA CIR
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City | LONGVIEW
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State | TX
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Zip | 75603-9611
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Country | US
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Telephone | 781-389-8443
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1157485
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1157485
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License Number State | TX
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