Provider Demographics
NPI:1669919742
Name:LORENTZ, CATHERINE BLAKESLEE (APRN, MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BLAKESLEE
Last Name:LORENTZ
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7181 N HUALAPAI WAY STE 130-11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1115
Mailing Address - Country:US
Mailing Address - Phone:904-718-3390
Mailing Address - Fax:
Practice Address - Street 1:7181 N HUALAPAI WAY STE 130-11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1115
Practice Address - Country:US
Practice Address - Phone:904-718-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002445363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1669919742Medicaid