Provider Demographics
NPI:1730733692
Name:LENTZ, WILLIAM THOMAS (NP-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:LENTZ
Suffix:
Gender:M
Credentials:NP-C
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Other - Credentials:
Mailing Address - Street 1:174 DUSTY ROSE DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6878
Mailing Address - Country:US
Mailing Address - Phone:314-560-2901
Mailing Address - Fax:
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:MAILSTOP 90-32-683
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-8134
Practice Address - Fax:314-454-8104
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2019029247363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner