Provider Demographics
NPI:1699554055
Name:LORTZ, AMANDA N
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:LORTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SPRINGER WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-5000
Mailing Address - Country:US
Mailing Address - Phone:614-307-1092
Mailing Address - Fax:
Practice Address - Street 1:124 SPRINGER WOODS BLVD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-5000
Practice Address - Country:US
Practice Address - Phone:614-307-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No372600000XNursing Service Related ProvidersAdult Companion