Provider Demographics
NPI:1619599867
Name:LORENZEN, FELECIA
Entity Type:Individual
Prefix:
First Name:FELECIA
Middle Name:
Last Name:LORENZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17645 WRIGHT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2195
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17645 WRIGHT ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2195
Practice Address - Country:US
Practice Address - Phone:402-332-7664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0002706-C-N363LF0000X
MI4704371131363LF0000X
NE2102363LF0000X
IAA157505363LF0000X
AZ256884363LF0000X
GAGAA-NP000211363LF0000X
IN71010907A363LF0000X
KS53-80097-112363LF0000X
KY3016026363LF0000X
MECNP211043363LF0000X
MO2021026890363LF0000X
NDR50371363LF0000X
OH0028828363LF0000X
TN29261363LF0000X
NE113302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily