Individual
DONNA M. LORNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11104 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1672
(260) 266-5370
(260) 266-5379
Mailing address
2512 E DUPONT RD STE 200, FORT WAYNE, IN 46825-1609
(260) 748-3650
(260) 748-3651
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001323A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000826595
ANTHEM
IN
05
—
0089199
—
OH
05
—
201085260
—
IN
Enumeration date
05/08/2012
Last updated
04/27/2016
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