Provider Demographics
NPI:1053408641
Name:LORSONG, NANCY V (CRNP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:V
Last Name:LORSONG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25830 BEE TREE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:MD
Mailing Address - Zip Code:21640-1449
Mailing Address - Country:US
Mailing Address - Phone:410-482-6044
Mailing Address - Fax:
Practice Address - Street 1:BACKBONE RD
Practice Address - Street 2:CHARLES DREW STUDENT HEALTH CENTER
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853
Practice Address - Country:US
Practice Address - Phone:410-651-6597
Practice Address - Fax:410-651-6702
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR071520363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner