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General NPI Number Information
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NPI Number | 1053408641
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Entity Type | Individual
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Provider Name | NANCY V LORSONG CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BACKBONE RD CHARLES DREW STUDENT HEALTH CENTER
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City | PRINCESS ANNE
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State | MD
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Zip | 21853
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Country | US
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Telephone | 410-651-6597
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Fax | 410-651-6702
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Provider Business Mailing Address
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Address Line | 25830 BEE TREE RD
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City | HENDERSON
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State | MD
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Zip | 21640-1449
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Country | US
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Telephone | 410-482-6044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R071520
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License Number State | MD
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