Healthcare Provider Details

I. General information

NPI: 1629808076
Provider Name (Legal Business Name): ANNE METTE CHRISTINE LACHMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 09/15/2024
Certification Date: 09/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10964 CARLTON FIELDS DR
RIVERVIEW FL
33579-3215
US

IV. Provider business mailing address

10964 CARLTON FIELDS DR
RIVERVIEW FL
33579-3215
US

V. Phone/Fax

Practice location:
  • Phone: 219-670-1890
  • Fax:
Mailing address:
  • Phone: 219-670-1890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11035278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: