Provider Demographics
NPI:1528492907
Name:CALLOWAY, LORI A (APRN-FNP)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:CALLOWAY
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:CALLOWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:8274 GLEN ECHO DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4552
Mailing Address - Country:US
Mailing Address - Phone:404-840-2044
Mailing Address - Fax:314-389-2954
Practice Address - Street 1:1500 21ST ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5216
Practice Address - Country:US
Practice Address - Phone:916-443-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016042033363LF0000X
GA168972163WH0200X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice