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NPI Code Detail

MEDICARE: MRS. LORI ANN FIRESTONE NP

MEDICARE: MRS. LORI ANN FIRESTONE NP
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 NurseRN116297TN
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN7647TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14186544OTHERTNBCBS

General Provider Information

NPI Number : 1922145283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORI ANN FIRESTONE NP
Provider Business Mailing Address
First Line : 3555 KEITH ST NW
Second Line : SUITE 102
City : CLEVELAND
State : TN
Zip : 37312-4375
Country : US
Telephone Number : 423-728-2282
Fax Number :
Provider Business Practice Location Address
First Line : 3555 KEITH ST NW
Second Line : SUITE 102
City : CLEVELAND
State : TN
Zip : 37312-4375
Country : US
Telephone Number : 423-728-2282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/21/2009

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Directions to “ MRS. LORI ANN FIRESTONE NP” Practice Location

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