Provider Demographics
NPI:1760444509
Name:LORENZ, ELLEN V (CFNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:V
Last Name:LORENZ
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3221 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-1222
Mailing Address - Country:US
Mailing Address - Phone:928-910-7010
Mailing Address - Fax:928-910-7011
Practice Address - Street 1:3221 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1222
Practice Address - Country:US
Practice Address - Phone:928-910-7010
Practice Address - Fax:928-910-7011
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN026464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine