Lorrie Lee Etenburn, CST/CFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

976 Agate CT
Fruita, CO 81521-3224

Phone

(970) 812-6975

NPI assigned

Jun 10, 2011

Last updated

Apr 25, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1104111889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 AGATE CT",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815213224",
            "telephone_number": "970-812-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 AGATE CT",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815213224",
            "telephone_number": "970-812-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETENBURN",
        "first_name": "LORRIE",
        "middle_name": "LEE",
        "credential": "CST/CFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Assistant in Fruita, CO
• Providers in Fruita, CO by specialty
• Surgical Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.