Provider Demographics
NPI:1336130582
Name:LENARZ, DENISE L (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:LENARZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-654-3630
Mailing Address - Fax:320-654-3657
Practice Address - Street 1:1900 CENTRACARE CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-654-3630
Practice Address - Fax:320-654-3657
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
127831OtherUCARE
992444OtherARAZ GROUP AMERICAS PPO
HP30491OtherHEALTH PARTNERS
86D70LEOtherBLUE CROSS BLUE SHIELD
1023250OtherPREFERRED ONE
1200745OtherMEDICA
2114095OtherFIRST HEALTH PLAN
519127100OtherMEDICAL ASSISTANCE
519127100OtherMEDICAL ASSISTANCE
H05415Medicare UPIN
370002072Medicare ID - Type Unspecified