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General NPI Number Information
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NPI Number | 1417388083
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Entity Type | Individual
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Provider Name | HEIDI RENEE LUTZ PHD, CRNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 954 ISABEL DR
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City | LEBANON
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State | PA
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Zip | 17042-7482
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Country | US
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Telephone | 717-376-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 DOVER RD
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City | HARRISBURG
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State | PA
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Zip | 17112-1002
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Country | US
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Telephone | 717-657-2111
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Fax | 717-657-0110
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP013443
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License Number State | PA
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