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NPI Code Detail

MEDICARE: LORI K WITMER APRN/BC, FNP

MEDICARE: LORI K WITMER APRN/BC, FNP
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
1163W00000XRegistered NurseRN0000124957TN
2363LF0000XFamily Nurse PractitionerAPN0000007939TN
3363LF0000XFamily Nurse PractitionerA003937AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1367978OTHERANCC
2A003937OTHERARAPRN, FNP
3RN0000124957OTHERTNRN LICENSE
43772OTHERARCERTIFICATE OF PRESCRIPTIVE AUTHORITY
5APN0000007939OTHERTNAPN LICENSE

General Provider Information

NPI Number : 1659307247
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI K WITMER APRN/BC, FNP
Provider Business Mailing Address
First Line : 2595 CENTRAL AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-5905
Country : US
Telephone Number : 901-260-8500
Fax Number : 901-260-8598
Provider Business Practice Location Address
First Line : 969 FRAYSER BLVD
Second Line : COMMUNITY FAMILY MEDICAL
City : MEMPHIS
State : TN
Zip : 38127-5977
Country : US
Telephone Number : 901-701-2540
Fax Number : 901-260-8449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2006
Last Update Date : 03/30/2015

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