Healthcare Provider Details

I. General information

NPI: 1336121391
Provider Name (Legal Business Name): SHEILA ANNE LORENTZEN C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4507
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 970-231-4012
  • Fax:
Mailing address:
  • Phone: 970-231-4012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number97159
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: