Healthcare Provider Details

I. General information

NPI: 1922629781
Provider Name (Legal Business Name): LANA L. MERRITT RN.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 ELMER ST
LYONS NY
14489-1305
US

IV. Provider business mailing address

49 HAGER RD. ROCH, NY 14616
ROCHESTER NY
14616
US

V. Phone/Fax

Practice location:
  • Phone: 585-721-8175
  • Fax:
Mailing address:
  • Phone: 585-721-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number639598
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: