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Ms. Lori Landreth, CPNP-PC
Pediatric Nurse Practitioner in Salem, Illinois
NPI 1790196244

Lori Landreth is a Pediatric Nurse Practitioner based in Salem, IL and is specialized in Pediatrics. Lori Landreth practices in Salem, IL and has the professional credentials of CPNP-PC. The NPI Number for Lori Landreth is 1790196244 and holds a License No. 209.011381 (Illinois).

The current practice location address for Lori Landreth is 1275 Hawthorn Rd, Salem, IL and can be reached out via phone at 618-548-4590 and via fax at 618-548-8275.

Location: 1275 Hawthorn Rd, Salem, IL, 62881-1028
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Provider Profile Details
NPI Number
1790196244
Provider Name
Lori Landreth
Credential
CPNP-PC
Provider Entity Type
Individual
Gender
Female
Address
1275 Hawthorn Rd, Salem, IL, 62881-1028
Phone Number
618-548-4590
Fax Number
618-548-8275
Provider Enumeration Date
05/17/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HU297Z 01 FL MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1275 Hawthorn Rd
City
State
Zip
62881-1028
Phone Number
618-548-4590
Fax Number
618-548-8275
person
Provider Business Mailing Address Details
Address
1275 Hawthorn Rd
City
State
Zip
62881-1028
Phone Number
618-548-4590
Fax Number
618-548-8275
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
209.011381 (Illinois)
Definition
Definition to come...
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