Provider Demographics
NPI:1154219699
Name:VASQUEZ-KIRK, LORENZA REBECA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LORENZA
Middle Name:REBECA
Last Name:VASQUEZ-KIRK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:LORENZA
Other - Middle Name:REBECA
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:120 N FORREST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:OK
Mailing Address - Zip Code:74872-4652
Mailing Address - Country:US
Mailing Address - Phone:580-759-0022
Mailing Address - Fax:
Practice Address - Street 1:120 N FORREST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:OK
Practice Address - Zip Code:74872-4652
Practice Address - Country:US
Practice Address - Phone:580-759-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK225162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health