Provider Demographics
NPI:1073858734
Name:LORENTZEN, ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:
Last Name:LORENTZEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 OLD HOT SPRINGS RD
Mailing Address - Street 2:SUITE 157
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0782
Mailing Address - Country:US
Mailing Address - Phone:775-684-4006
Mailing Address - Fax:775-687-5975
Practice Address - Street 1:485 W B ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2764
Practice Address - Country:US
Practice Address - Phone:775-423-4434
Practice Address - Fax:775-423-0422
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN05424163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse