Provider Demographics
NPI:1154219699
Name:VASQUEZ-KIRK, LORENZA REBECA (PMHNP-C)
Entity type:Individual
Prefix:
First Name:LORENZA
Middle Name:REBECA
Last Name:VASQUEZ-KIRK
Suffix:
Gender:F
Credentials:PMHNP-C
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 1:212 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-7604
Mailing Address - Country:US
Mailing Address - Phone:806-470-7240
Mailing Address - Fax:
Practice Address - Street 1:212 W 16TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-7604
Practice Address - Country:US
Practice Address - Phone:806-470-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0135879163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse