MEDICARE: MRS. LORI MARIE MCATEE LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	147863	OH

General Provider Information

NPI Number	:	1023383189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI MARIE MCATEE LPN

Provider Business Mailing Address
First Line	:	205 MAPLE ST
Second Line	:
City	:	SAINT PARIS
State	:	OH
Zip	:	43072-9790
Country	:	US
Telephone Number	:	937-206-0094
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 MAPLE ST
Second Line	:
City	:	SAINT PARIS
State	:	OH
Zip	:	43072-9790
Country	:	US
Telephone Number	:	937-206-0094
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2012
Last Update Date	:	03/21/2012

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