Basic Information
| Provider Information | |||||||||
| NPI: | 1730204223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUNTINGTON | ||||||||
| FirstName: | LORIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 867 | ||||||||
| Address2: | 105 WEST 100 NORTH | ||||||||
| City: | PRICE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 845010867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356377200 | ||||||||
| FaxNumber: | 4356372377 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 EAST 100 SOUTH | ||||||||
| Address2: | |||||||||
| City: | CASTLE DALE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4353812432 | ||||||||
| FaxNumber: | 4353812542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 12/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 283754-3101 | UT | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.