Individual
MS. JACQUELINE LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1365 W 29TH ST, LOVELAND, CO 80538-2561
(970) 667-6111
(970) 482-0198
Mailing address
802 W DRAKE RD, FORT COLLINS, CO 80526-5558
(970) 494-6449
(970) 482-0198
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201050005NP
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
2008006015
OR
363LG0600X
Gerontology Nurse Practitioner
2008006016
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500619570
—
OR
Enumeration date
01/13/2010
Last updated
12/28/2015
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