Provider Demographics
NPI:1184442337
Name:REITER, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:REITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 OLDE TOWNE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4396
Mailing Address - Country:US
Mailing Address - Phone:704-407-2407
Mailing Address - Fax:
Practice Address - Street 1:4800 OLDE TOWNE PKWY STE 350
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4396
Practice Address - Country:US
Practice Address - Phone:470-407-2407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN176475163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory