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General NPI Number Information
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NPI Number | 1619967569
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Entity Type | Individual
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Provider Name | JAN LORENZ PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 108 WOODS RUN
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City | ROLLINSFORD
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State | NH
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Zip | 03869-0386
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Country | US
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Telephone | 903-780-2926
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Fax |
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Provider Business Mailing Address
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Address Line | 108 WOODS RUN
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City | ROLLINSFORD
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State | NH
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Zip | 03869
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Country | US
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Telephone | 562-296-2959
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Fax | 903-213-9185
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | CNP171177
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2005000649
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License Number State | TX
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