Beth Winifred Lorenz, PA-C
Individual provider Active NPI Physician Assistant · Moultonborough, NH
NPI 1124027396 · NPPES record last updated Oct 22, 2012
Key facts
- NPI
- 1124027396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0210P (NH)
- Practice address
- 984 Whittier Highway
Moultonborough, NH 03254 - Phone
- (603) 476-2216
- Fax
- (603) 476-5396
- NPI assigned
- Jul 19, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0210 | NH | MD | Addiction (Substance Use Disorder) Counselor |
| 210 | NH | MD | Podiatrist |
| 0210P | NH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LRG Healthcare | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0210P | NH | Yes |
Addresses
Primary practice location
984 Whittier Highway
Moultonborough, NH 03254
Mailing address
PO Box 655
Moultonboro, NH 03254-0655
Phone (603) 253-3178
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30331636 | Medicaid | NH |
Other names
- Beth Winifred Coleman Lorenz
Other providers in Moultonborough, NH
- Greater Accord Health Inc
- Huggins Hospital
- Joseph Cariello DDS PC
- Ava Knoll
- Hai Liu
- Morgan Lee Macaione
- Meadow Pond Animal Hopsital
- Merkaba Sacred Healing & Counseling PLLC
- Moultonborough School District
- Heather L Nelson
All providers in Moultonborough, NH · Physician Assistant in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.