Provider Demographics
NPI:1306874052
Name:ELMORE, LORI JILL (MSN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:JILL
Last Name:ELMORE
Suffix:
Gender:F
Credentials:MSN, CPNP-PC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:JILL
Other - Last Name:GETTELFINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W A J HWY
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:255 E WATT ST
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2236
Practice Address - Country:US
Practice Address - Phone:865-273-1616
Practice Address - Fax:865-273-1645
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 0000006762363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000942OtherCERTIFICATE OF FITNESS
TNRN0000093981OtherRN LICENSE
TNTN0104OtherJOHN DEERE ID #
TNAPN000006762OtherADVANCE PRACTICE NURSE
TNAPN000006762OtherADVANCE PRACTICE NURSE