Provider Demographics
NPI:1699122093
Name:TREXLER, LORI (MS, OTR)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:TREXLER
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 BEAVERTON TRL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5269
Mailing Address - Country:US
Mailing Address - Phone:336-978-9944
Mailing Address - Fax:
Practice Address - Street 1:1424 BEAVERTON TRL
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5269
Practice Address - Country:US
Practice Address - Phone:336-978-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4947314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility