Healthcare Provider Details

I. General information

NPI: 1093344244
Provider Name (Legal Business Name): ROBYN N LANASA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 MAIN ST
CHESTER MD
21619-2791
US

IV. Provider business mailing address

1630 MAIN ST
CHESTER MD
21619-2791
US

V. Phone/Fax

Practice location:
  • Phone: 410-604-6560
  • Fax:
Mailing address:
  • Phone: 410-604-6560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR165610
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR165610
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: