MEDICARE: MRS. LORI MELTON POINDEXTER APRN

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	363LF0000X	Family Nurse Practitioner	3008582	KY

General Provider Information

NPI Number	:	1497171292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI MELTON POINDEXTER APRN

Provider Business Mailing Address
First Line	:	PO BOX 456
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-0456
Country	:	US
Telephone Number	:	606-387-3000
Fax Number	:	606-387-3307

Provider Business Practice Location Address
First Line	:	250 BURKESVILLE RD
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1604
Country	:	US
Telephone Number	:	606-387-3000
Fax Number	:	606-387-3307

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

Provider Enumeration Date	:	03/17/2014
Last Update Date	:	11/20/2017

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