Provider Demographics
NPI:1710753587
Name:LORENZ, ANDREA L (MSN, CNM)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:LORENZ
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 PALMER PL
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964-1525
Mailing Address - Country:US
Mailing Address - Phone:215-876-7012
Mailing Address - Fax:
Practice Address - Street 1:770 HOST RD
Practice Address - Street 2:
Practice Address - City:WOMELSDORF
Practice Address - State:PA
Practice Address - Zip Code:19567-9100
Practice Address - Country:US
Practice Address - Phone:717-933-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN665379163WM0102X
PAMW010764367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn