Can anyone explain if this guy I know is pretending to be a LTC?

LTC is a bit much; however, the reserves have opening for which they fill based on experience, so your friend could have dumb-lucked into one of the jobs [your friend would be a Civil Service Employee during the week and a LTC on the weekend the duty is performed]. I met a E-5 who was in the Reserves and who also worked Civil Service. One day I see him and he was wearing E8 stripes [I was shocked to say the least]. He was a "Reserve Technician" and had been promoted to a Reserve slot of E-8; however, his Civil Service position was WL-3. After a number of years his Civil Service position was upgraded to reflect the military rank. So...YES, IT COULD HAVE HAPPENED IN THE RESERVES.

The last Army Reserve unit attached to the 101st was the 101st Airborne Division Detachment in September 2006. In theory, he could join the reserves at 45 through an AMED recruiter but with only a bachelors in nursing, he’d likely come in as a CPT at best. He’d have to be a Neurosurgeon or some very highly specialized or critical shortage doctor to come in as a LTC. But since you can’t find him on global or AKO, he’s likely a fake.

It is possible. The Army does have recruiters (at HRC, Ft Knox) that recruit those special skills from the civillian community .
I've seen them several times come on active duty as a Captain through Colonel.
Mostly in the medical field.
The guy recruited as a Colonel was an experienced neurosurgeon.

Geez, I wish we had Lifeguards at the Gene Pool! He's densely continent of fecal material. Yes, he is absolutely full of shit. I didn't get to serve long, but I served honorably and have my membership card to the DD-214 Club! I understand "Stolen Valor" and these other concepts brought about by the rise of these lying rectal mouthpieces: I think we need to make "Lying Dumb-Ass" a felony! If not, it should at least HURT!

I don't know, I mean I'm a cpl capt, secret squirrel bomb loader tgat got "BLOWN UP SIR" AND that I never had to go to buds to be a seal because my masters in basket weaving got me a doctorate in sniper school with the 357th Marine Airwing as a jump Master class of 81 while scuba diving with a non rebreather out of a submarine that was parked at 22,000 feet below the surface off of the coast of N Korea last week getting me a promotion to a 7 star General so yea it's totally possible!

No offence to Nurses but they are a "dime a dozen." The chances of being direct commissioned as a LTC for most Nurses is zero. If this one is a Nurse Practitioner it's possible, but not likely. It's of course possible to have been attached to the 101 and thus have a right arm patch that says "Airborne," but not likely. It's far more likely that for this guy it's Halloween every day. If he's not on AKO he is not currently serving. He's not been in long enough for a retirement either so I think you're right... it stinks.

Very fishy. I have heard of physicians being commissioned in that grade, never in the Nurse Corps with only a BS degree. Ask him to accompany you to the PX or Commissary. The gate guard will ask for his CAC card and bust him if he’s lying

Fish is not the smell, it's the stolden identity and disrespect he has for those who have and are serving regardless of rank. Someone should report this person to stop his disrespect of our men and women who are putting their lives on the line defending our Nation and right to live free.

I have seen physicians come in as an O-5, it is rare. A BSN with 20 years of experience might get you to come in as an O-4. maybe.
Ask to see his CAC. However, I have seen fake CACs that are made to impress/fool civilians.

BS. You summed it up right there.