Provider Demographics
NPI:1386742716
Name:NOVOSEL, LORRAINE (ARNP)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:NOVOSEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GOODLETTE RD N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5400
Mailing Address - Country:US
Mailing Address - Phone:239-643-8710
Mailing Address - Fax:239-262-8465
Practice Address - Street 1:800 GOODLETTE RD N
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5400
Practice Address - Country:US
Practice Address - Phone:239-643-8710
Practice Address - Fax:239-262-8465
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3271612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9481OtherBCBS PROVIDER #
FLE3022Medicare ID - Type UnspecifiedMEDICARE #
FLY9481OtherBCBS PROVIDER #