Provider Demographics
NPI:1336255819
Name:LORENCZ, SUSAN (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LORENCZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GIRLTALK & GYNECOLOGY
Mailing Address - Street 2:4251 ARENDELL ST. SUITE C
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557
Mailing Address - Country:US
Mailing Address - Phone:252-222-0660
Mailing Address - Fax:252-222-0663
Practice Address - Street 1:GIRLTALK & GYNECOLOGY
Practice Address - Street 2:4251 ARENDELL ST. SUITE C
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557
Practice Address - Country:US
Practice Address - Phone:252-222-0660
Practice Address - Fax:252-222-0663
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002029363L00000X
NC183193363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9782BMedicare PIN