Individual
MRS. KIMBERLY R LORENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109
(573) 556-1706
(573) 556-1718
Mailing address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 556-1706
(573) 556-1718
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2012008569
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147034
STATE RN LICENSE
MO
01
—
2012008569
ADULT NURSE PRACTITIONER LICENSE
MO
Enumeration date
02/29/2012
Last updated
06/15/2018
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