Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | NC |
NPI | 1346213501 |
---|---|
Provider Name | Dr. Vicki M. Lanier |
First Address | Elizabethtown, NC 28337-0447 |
Second Address | Fort Bragg, NC 28310-7324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2234531A | (05) | NC |
G45320 | (02) | NC |