Provider Demographics
NPI:1104611573
Name:LENZEN, AGNES
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:LENZEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-0703
Mailing Address - Country:US
Mailing Address - Phone:308-250-2802
Mailing Address - Fax:
Practice Address - Street 1:2459 11TH AVE APT 115
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2368
Practice Address - Country:US
Practice Address - Phone:308-250-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide