Provider Demographics
NPI:1396520573
Name:LORENS, ARTEM I
Entity type:Individual
Prefix:
First Name:ARTEM
Middle Name:I
Last Name:LORENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 CYPRESS POINT PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8427
Mailing Address - Country:US
Mailing Address - Phone:386-283-5654
Mailing Address - Fax:
Practice Address - Street 1:145 CYPRESS POINT PKWY STE 105
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8427
Practice Address - Country:US
Practice Address - Phone:386-283-5654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily