Lori Jo Bacon, RN
Individual provider Active NPI Registered Nurse · Topeka, KS
NPI 1043913486 · NPPES record last updated Mar 24, 2023
Key facts
- NPI
- 1043913486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 13-49659-072 (KS)
- Practice address
- 2200 SW Gage Blvd
Topeka, KS 66622-0001 - Phone
- (785) 350-3111
- NPI assigned
- Mar 24, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13-49659-072 | KS | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 13-49659-072 | KS | Yes |
Addresses
Primary practice location
2200 SW Gage Blvd
Topeka, KS 66622-0001
Mailing address
2200 SW Gage Blvd
Topeka, KS 66622-0001
Phone (785) 350-3111
Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.