Provider Demographics
NPI:1285172908
Name:FOLMAR, LORI LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNN
Last Name:FOLMAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:BREVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1194
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 NW HIGHWAY 101
Practice Address - Street 2:SUITE A
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-3241
Practice Address - Country:US
Practice Address - Phone:541-996-7480
Practice Address - Fax:541-557-6439
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201701862NP-PP363LF0000X
OR201041933RN163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency