Provider Demographics
NPI:1699108373
Name:FEHR, LORI L (PA)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:L
Last Name:FEHR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7153 TARPON CT
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3785
Mailing Address - Country:US
Mailing Address - Phone:904-237-6558
Mailing Address - Fax:
Practice Address - Street 1:18167 U.S. HIGHWAY 19N, SUITE 650
Practice Address - Street 2:EMCARE ATTN: LAURIE
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764
Practice Address - Country:US
Practice Address - Phone:727-533-8709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant