Basic Information
| Provider Information | |||||||||
| NPI: | 1609010347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCAUGHEY | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | REGISTERED NURSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7025 WELLS FARGO WAY | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960219009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303849849 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1860B WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | RED BLUFF | ||||||||
| State: | CA | ||||||||
| PostalCode: | 96080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305275637 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2009 | ||||||||
| LastUpdateDate: | 04/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 699273 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.