LORI ANGELEENE MODLY CPNP NPI 1871860692

NPI Information

NPI: 1871860692
Provider Name: LORI ANGELEENE MODLY, CPNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
743 SPRING ST NE
GAINESVILLE, GA
ZIP 30501
Phone: (770) 535-3611
Get Directions

Lori Angeleene Modly, CPNP is a pediatrics nurse practitioner in Gainesville, GA. Lori Angeleene Modly, CPNP NPI is 1871860692. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

743 SPRING ST NE
GAINESVILLE, GA
ZIP 30501-715
Phone: (770) 535-3611
Fax: (770) 535-7092

The enumeration date for this NPI number is 11/22/2011 and was last updated on 2/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	RN201247	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01467542	OTHER	GEORGIA	AMERIGROUP
2	202I503620	MEDICARE PIN	GEORGIA
3	643406	OTHER	GEORGIA	WELLCARE
4	003116595A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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