Provider Demographics
NPI:1396772810
Name:LORENZ, KRISTINA (FNPC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LORENZ
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:KRISSY
Other - Middle Name:
Other - Last Name:LORENZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4005 HENDERSONVILLE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8240
Mailing Address - Country:US
Mailing Address - Phone:828-667-9155
Mailing Address - Fax:828-667-9245
Practice Address - Street 1:4005 HENDERSONVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-8240
Practice Address - Country:US
Practice Address - Phone:828-667-9155
Practice Address - Fax:828-667-9245
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201711363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
200619OtherUNITED HEALTHCARE PROV. #
ML0918776OtherDEA #
NC7000387Medicaid
200619OtherUNITED HEALTHCARE PROV. #
2807768Medicare ID - Type Unspecified