Provider Demographics
NPI:1194160226
Name:FENDELL, LORRAINE (LAC, PA, MPH)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:FENDELL
Suffix:
Gender:F
Credentials:LAC, PA, MPH
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:FENDELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2904 HILLSBOROUGH RD
Mailing Address - Street 2:TRADITIONAL ACUPUNCTURE
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4048
Mailing Address - Country:US
Mailing Address - Phone:919-286-0662
Mailing Address - Fax:
Practice Address - Street 1:2904 HILLSBOROUGH RD
Practice Address - Street 2:TRADITIONAL ACUPUNCTURE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4048
Practice Address - Country:US
Practice Address - Phone:919-286-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist