Lorrie Ann Formella
Specialist/Technologist, Athletic Trainer in Appleton, WI. Individual provider (NPI-1).
NPI number1982252631
StatusActive
Last updated in NPPESAug 27, 2019
Details
- NPI
- 1982252631
- Entity type
- Individual (NPI-1)
- Name
- Lorrie Ann Formella
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 27, 2019
- Last updated
- Aug 27, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
604 N Richmond StAppleton, WI 54911-4659
Phone 920-750-1845
Mailing address
N7590 Lower Cliff RdSherwood, WI 54169-9704
Phone 920-750-1845
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 46 Athletic Trainer providers in Appleton · All 4,063 providers in Appleton
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