Provider Demographics
NPI:1194987172
Name:FIELDING, LORA LYNN (AID)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:LYNN
Last Name:FIELDING
Suffix:
Gender:F
Credentials:AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 CALLAHAN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:45369-9715
Mailing Address - Country:US
Mailing Address - Phone:937-408-8141
Mailing Address - Fax:
Practice Address - Street 1:101 E COLUMBUS RD APT 214
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:OH
Practice Address - Zip Code:45368-9335
Practice Address - Country:US
Practice Address - Phone:937-462-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker