Provider Demographics
NPI:1306252408
Name:AUSTIN, LORI LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Other - First Name:
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Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:4131 UNIVERSITY BLVD S STE 8
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4351
Practice Address - Country:US
Practice Address - Phone:904-733-3992
Practice Address - Fax:904-737-4344
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN3391612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105689600Medicaid
FLOF854OtherMEDICARE