MEDICARE: LORI SAUNDERS RN FNP-BC

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	163W00000X	Registered Nurse	RN60311610	WA
2	363L00000X	Nurse Practitioner	AP60311613	WA
3	363LF0000X	Family Nurse Practitioner	11697	CA
4	363LF0000X	Family Nurse Practitioner	301578	CA

General Provider Information

NPI Number	:	1215991088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI SAUNDERS RN FNP-BC

Provider Business Mailing Address
First Line	:	39662 FOXTAIL DR
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92591-0311
Country	:	US
Telephone Number	:	760-468-7249
Fax Number	:

Provider Business Practice Location Address
First Line	:	28078 BAXTER RD STE 530
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-1405
Country	:	US
Telephone Number	:	951-566-5229
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	01/14/2022

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