| NPI | 1801397096 |
|---|---|
| Former Name | LORI BETH MCMAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23876) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902571) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2025-06-16 |