Provider Demographics
NPI:1154420834
Name:DEMKO, LORI A (CRNP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:DEMKO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4804
Mailing Address - Country:US
Mailing Address - Phone:412-371-9133
Mailing Address - Fax:412-371-9360
Practice Address - Street 1:620 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4804
Practice Address - Country:US
Practice Address - Phone:412-371-9133
Practice Address - Fax:412-371-9360
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017015363LA2100X
PARN520230L163W00000X
PASP009122363LA2100X
GARN284088363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
105890Medicare PIN
PA186981HSZMedicare PIN