MEDICARE: MRS. LORI CHRISTINE MILOVANOVIC LPN

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	164W00000X	Licensed Practical Nurse	5711	AK

General Provider Information

NPI Number	:	1932170495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI CHRISTINE MILOVANOVIC LPN

Provider Business Mailing Address
First Line	:	3632 RON CIR
Second Line	:
City	:	NORTH POLE
State	:	AK
Zip	:	99705-6829
Country	:	US
Telephone Number	:	907-353-1207
Fax Number	:	907-353-4850

Provider Business Practice Location Address
First Line	:	3632 RON CIR
Second Line	:
City	:	NORTH POLE
State	:	AK
Zip	:	99705-6829
Country	:	US
Telephone Number	:	907-353-1207
Fax Number	:	907-353-4850

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/08/2007

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