| NPI | 1851584361 |
|---|---|
| Former Name | LORI JO HACKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN140976) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA RN140976 CRNA) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-04-09 |