Provider Demographics
NPI:1265981997
Name:DIRICCO, LORRAINE JEANETTE (APRN, RN)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:JEANETTE
Last Name:DIRICCO
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 W FRANCIS AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6858
Mailing Address - Country:US
Mailing Address - Phone:509-934-1925
Mailing Address - Fax:509-868-0874
Practice Address - Street 1:1717 W FRANCIS AVE STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205
Practice Address - Country:US
Practice Address - Phone:509-934-1925
Practice Address - Fax:509-868-0874
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60090663163WP0808X
AKNURR35583163WP0808X
WAAP60809756363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health