Individual
ELLEN LENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
5461 MAYFLOWER #4, WASILLA, AK 99654
(907) 376-4644
(907) 745-0226
Mailing address
5461 MAYFLOWER #4, WASILLA, AK 99654
(907) 376-4644
(907) 745-0226
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16188
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16188
LICENSE NUMBER
AK
05
—
NP0554
—
AK
Enumeration date
09/06/2006
Last updated
07/08/2007
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