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NPI Code Detail

MEDICARE: AMY CAMPBELL LORENZO CRNP

MEDICARE: AMY CAMPBELL LORENZO CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerUP006962CPA

General Provider Information

NPI Number : 1447254362
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY CAMPBELL LORENZO CRNP
Provider Business Mailing Address
First Line : 3400 SPRUCE STREET
Second Line : 4 SILVERSTEIN
City : PHILADELPHIA
State : PA
Zip : 19104
Country : US
Telephone Number : 215-662-2626
Fax Number :
Provider Business Practice Location Address
First Line : 3400 SPRUCE ST
Second Line : 4 SILVERSTEIN BUILDING
City : PHILADELPHIA
State : PA
Zip : 19104-4206
Country : US
Telephone Number : 215-662-2626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 05/21/2013

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