Provider Demographics
NPI:1285345603
Name:DOOLEN, LORI (RN IBCLC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DOOLEN
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RICHARDS RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04849-5615
Mailing Address - Country:US
Mailing Address - Phone:207-323-5780
Mailing Address - Fax:
Practice Address - Street 1:40 RICHARDS RD
Practice Address - Street 2:
Practice Address - City:LINCOLNVILLE
Practice Address - State:ME
Practice Address - Zip Code:04849-5615
Practice Address - Country:US
Practice Address - Phone:207-323-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME48472163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant