Provider Demographics
NPI:1053352369
Name:RIZOR, LORI A (CRNA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:RIZOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711841
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-0001
Mailing Address - Country:US
Mailing Address - Phone:304-346-9400
Mailing Address - Fax:304-720-8461
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:MONONGALIA GENRAL HOSPITAL
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-285-1245
Practice Address - Fax:304-285-2131
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52027367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001706470OtherMSBCBS GROUP
WVDA0096OtherRR MEDICARE
WV27005299700OtherWORKERS COMP
WVP00282628OtherRR MEDICARE
WV270052997003OtherTRICARE
WV277747205OtherTRICARE
WV001788764OtherBCBS
WV3810004810Medicaid
WV0207026000Medicaid
WV270052997004OtherTRI CARE
WV0069146000Medicaid
WV001788764OtherBCBS
WV270052997003OtherTRICARE
WV8236681Medicare PIN