Basic Information
| Provider Information | |||||||||
| NPI: | 1629603519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VOGT | ||||||||
| FirstName: | LORINE | ||||||||
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| Credential: | CNM, WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2351 CHESTER SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | CHESTER SPRINGS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194253403 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 INDEPENDENCE BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SICKLERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080811039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563418474 | ||||||||
| FaxNumber: | 8563255003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2020 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 104606269 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | CNM06261 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 25ME00072501 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | RN692771 | 01 | PA | RN LICENSE | OTHER |