Provider Demographics
NPI:1053992552
Name:SHEARER, LORRAINE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:SHEARER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4034 BURNT MILL RD
Mailing Address - Street 2:
Mailing Address - City:INTERLOCHEN
Mailing Address - State:MI
Mailing Address - Zip Code:49643-9241
Mailing Address - Country:US
Mailing Address - Phone:219-789-0991
Mailing Address - Fax:
Practice Address - Street 1:4034 BURNT MILL RD
Practice Address - Street 2:
Practice Address - City:INTERLOCHEN
Practice Address - State:MI
Practice Address - Zip Code:49643-9241
Practice Address - Country:US
Practice Address - Phone:219-789-0991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date: