Provider Demographics
NPI:1962843193
Name:LORBER, NANCY ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LORBER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 CLARE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3374
Mailing Address - Country:US
Mailing Address - Phone:360-479-6154
Mailing Address - Fax:206-241-4429
Practice Address - Street 1:2720 CLARE AVE STE A
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3374
Practice Address - Country:US
Practice Address - Phone:360-479-6154
Practice Address - Fax:206-241-4429
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60397449363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2029937Medicaid