Provider Demographics
NPI:1215990742
Name:LERZ, KATHRYN A (MSN, APRN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:LERZ
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 CAMPBELL AVE
Mailing Address - Street 2:WEST HAVEN VA
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2700
Mailing Address - Country:US
Mailing Address - Phone:203-932-5711
Mailing Address - Fax:203-937-4784
Practice Address - Street 1:950 CAMPBELL AVE
Practice Address - Street 2:VA CONNECTICUT HEALTHCARE SYSTEM
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2700
Practice Address - Country:US
Practice Address - Phone:203-932-5711
Practice Address - Fax:203-937-4784
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003288363LA2100X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology