Basic Information
Provider Information
NPI: 1003005042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEUTSCH
FirstName: LORI
MiddleName: LEE
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5220 COLLEGE RD
Address2:  
City: KEY WEST
State: FL
PostalCode: 330404302
CountryCode: US
TelephoneNumber: 3052941089
FaxNumber: 3052961530
Practice Location
Address1: 5220 COLLEGE RD
Address2:  
City: KEY WEST
State: FL
PostalCode: 330404302
CountryCode: US
TelephoneNumber: 3052941089
FaxNumber: 3052961530
Other Information
ProviderEnumerationDate: 10/16/2007
LastUpdateDate: 10/16/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0400XRN1375042FLY Nursing Service ProvidersRegistered NurseCase Management

No ID Information.


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