Provider Demographics
NPI:1447594320
Name:DENMARK, LORI ELAINE (ANP-BC, GNP-BC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ELAINE
Last Name:DENMARK
Suffix:
Gender:F
Credentials:ANP-BC, GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7260
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 330
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-269-4545
Practice Address - Fax:615-565-6748
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21974363LA2200X
TN17105363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01376516OtherRR MEDICARE
TN6011930OtherBCBS
TNQ010703Medicaid
TNP01376516OtherRR MEDICARE