Basic Information
Provider Information | |||||||||
NPI: | 1427369032 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LORENCO | ||||||||
FirstName: | HILLARY | ||||||||
MiddleName: | JOY | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | RN, MSN, CPNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | COLLYER | ||||||||
OtherFirstName: | HILLARY | ||||||||
OtherMiddleName: | JOY | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | RN, MSN, CPNP | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 16149 | ||||||||
Address2: |   | ||||||||
City: | RUMFORD | ||||||||
State: | RI | ||||||||
PostalCode: | 029160697 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4018542428 | ||||||||
FaxNumber: | 4014357069 | ||||||||
Practice Location | |||||||||
Address1: | 2 DUDLEY ST | ||||||||
Address2: | SUITE 190 | ||||||||
City: | PROVIDENCE | ||||||||
State: | RI | ||||||||
PostalCode: | 029053236 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4014211939 | ||||||||
FaxNumber: | 4018682319 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/29/2010 | ||||||||
LastUpdateDate: | 01/29/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/29/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | NPP37518 | RI | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 363LP0200X | APRN00381 | RI | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.