=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982547238
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LORI ANN HAINES RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/13/2026
-----------------------------------------------------
Last Update Date | 04/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1111 E END BLVD
-----------------------------------------------------
City | WILKES BARRE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18711-0030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-824-3521
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4911 WINDY VALLEY RD
-----------------------------------------------------
City | FORKSTON TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18629-5191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-855-3466
-----------------------------------------------------
Fax | 570-855-3466
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | RN651873
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------