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General NPI Number Information
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NPI Number | 1245316116
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Entity Type | Individual
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Provider Name | PAMELA J. LORENZ P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 802 STATE AVE NE
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City | WARROAD
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State | MN
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Zip | 56763-2702
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Country | US
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Telephone | 218-386-4234
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W MARKET ST STE 2900
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2964
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Country | US
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Telephone | 866-434-3255
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 9058
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAC0056
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License Number State | ND
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