Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 28057664 | IN |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 71002595 | IN |
NPI | 1134207541 |
---|---|
Provider Name | Debra L Lanie |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46237-8601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 10/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200423620 | (05) | IN |