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NPI Code Detail

MEDICARE: CHARLOTTE L LANTZ CFNP

MEDICARE: CHARLOTTE L LANTZ CFNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner36761WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245235969
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE L LANTZ CFNP
Provider Business Mailing Address
First Line : PO BOX 609
Second Line :
City : ELIZABETH
State : WV
Zip : 26143-0609
Country : US
Telephone Number : 304-275-3301
Fax Number : 304-275-4798
Provider Business Practice Location Address
First Line : 1301 ELIZABETH PIKE
Second Line :
City : ELIZABETH
State : WV
Zip : 26143-0609
Country : US
Telephone Number : 304-275-3301
Fax Number : 304-275-4798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 08/06/2021

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Directions to “ CHARLOTTE L LANTZ CFNP” Practice Location

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