1649588674 NPI number — MS. DOROTHY LENTZ RN

Table of content: MS. DOROTHY LENTZ RN (NPI 1649588674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649588674 NPI number — MS. DOROTHY LENTZ RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENTZ
Provider First Name:
DOROTHY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649588674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 WEST WETMORE RD. RM. 168
Provider Second Line Business Mailing Address:
PIMA COUNTY AMPHITHEATER SCHOOLS DBA AMPHITHEATER PUBLI
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85705-1547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-696-5237
Provider Business Mailing Address Fax Number:
520-696-5067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 WEST WETMORE RD. RM. 168
Provider Second Line Business Practice Location Address:
AMPHITHEATER PUBLIC SCHOOLS
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85705-1547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-696-5237
Provider Business Practice Location Address Fax Number:
520-696-5067
Provider Enumeration Date:
09/24/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN157355 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)