Healthcare Provider Details

I. General information

NPI: 1316039167
Provider Name (Legal Business Name): ANN M. LANSING RN, CARN-AP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 11TH AVE NW SUITE 300
ROCHESTER MN
55901-1805
US

IV. Provider business mailing address

602 11TH AVE NW SUITE 300
ROCHESTER MN
55901-1805
US

V. Phone/Fax

Practice location:
  • Phone: 507-292-1379
  • Fax: 507-289-4524
Mailing address:
  • Phone: 507-292-1379
  • Fax: 507-289-4524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number10683-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: