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NPI Code Detail

MEDICARE: GLENDA LORENZEN RN

MEDICARE: GLENDA LORENZEN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse48652NE

General Provider Information

NPI Number : 1780990432
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENDA LORENZEN RN
Provider Business Mailing Address
First Line : 2231 LINCOLN RD
Second Line :
City : BELLEVUE
State : NE
Zip : 68005-3907
Country : US
Telephone Number : 402-291-1203
Fax Number :
Provider Business Practice Location Address
First Line : 2231 LINCOLN RD
Second Line :
City : BELLEVUE
State : NE
Zip : 68005-3907
Country : US
Telephone Number : 402-291-1203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2010
Last Update Date : 08/19/2010

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