MEDICARE: MRS. LORI BORDELON BORDELON LEA DNP, 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	363LF0000X	Family Nurse Practitioner	05882	LA

General Provider Information

NPI Number	:	1821229220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI BORDELON BORDELON LEA DNP, FNP-BC

Provider Business Mailing Address
First Line	:	308 GRIFFITH ST
Second Line	:
City	:	PINEVILLE
State	:	LA
Zip	:	71360
Country	:	US
Telephone Number	:	318-528-5000
Fax Number	:	318-448-8013

Provider Business Practice Location Address
First Line	:	3000 SOUTH MACARTHUR DR.
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301
Country	:	US
Telephone Number	:	318-528-4080
Fax Number	:	318-441-9917

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

Provider Enumeration Date	:	08/03/2009
Last Update Date	:	01/08/2026

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