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General NPI Number Information
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NPI Number | 1700926185
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Entity Type | Individual
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Provider Name | LORIN J BACON ACNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 2345 FAIR OAKS BLVD # 2853
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City | SACRAMENTO
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State | CA
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Zip | 95825-4708
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Country | US
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Telephone | 916-480-6526
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Fax |
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Provider Business Mailing Address
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Address Line | 401 GARDNER CT
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City | FOLSOM
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State | CA
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Zip | 95630-9567
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Country | US
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Telephone | 916-353-1105
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 422161
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License Number State | CA
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