Healthcare Provider Details

I. General information

NPI: 1083936397
Provider Name (Legal Business Name): COLLEEN LENZ CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2010
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHNS HOPKINS HOSPITAL 601 NORTH CAROLINE STREET
BALTIMORE MD
21287-0001
US

IV. Provider business mailing address

1300 W 40TH ST
BALTIMORE MD
21211-1727
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-6493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR185831
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR185831
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: