Provider Demographics
NPI:1043686710
Name:LORENC, KRISTI (CNP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:LORENC
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2269
Mailing Address - Country:US
Mailing Address - Phone:419-824-7451
Mailing Address - Fax:419-824-7359
Practice Address - Street 1:6400 MONROE ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1453
Practice Address - Country:US
Practice Address - Phone:844-436-4987
Practice Address - Fax:866-390-9167
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704378256363L00000X
OH319200363L00000X
MI4704378259363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner