Individual
KATY JO LORENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
Mailing address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015442
IL
Other
Enumeration date
11/01/2017
Last updated
11/01/2017
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