Provider Demographics
NPI:1952593592
Name:LORENZ, SUSAN C (CRNA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:LORENZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1299 OLENTANGY RIVER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3140
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:111 S GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4701
Practice Address - Country:US
Practice Address - Phone:614-566-8808
Practice Address - Fax:614-566-9503
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN-272065367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2609896Medicaid
OHLO8236061Medicare PIN