Provider Demographics
NPI:1609973569
Name:JOYCE MICHELE LENTZ
Entity type:Organization
Organization Name:JOYCE MICHELE LENTZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:702-396-1437
Mailing Address - Street 1:6021 W CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4205
Mailing Address - Country:US
Mailing Address - Phone:702-396-1437
Mailing Address - Fax:702-396-1443
Practice Address - Street 1:6021 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4205
Practice Address - Country:US
Practice Address - Phone:702-396-1437
Practice Address - Fax:702-396-1443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN28058163W00000X
NVAPN00352163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS54933Medicare UPIN
NVV34998Medicare ID - Type Unspecified