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General NPI Number Information
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NPI Number | 1013996644
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Entity Type | Individual
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Provider Name | DEBORAH K LANIUS MSN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 113 LIELMANIS AVE 1 SOMDG
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City | HURLBURT FIELD
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State | FL
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Zip | 32544-5613
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Country | US
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Telephone | 850-881-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 7681 WHITE SANDS BLVD
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City | NAVARRE
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State | FL
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Zip | 32566-7120
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Country | US
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Telephone | 615-638-6241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000007880
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License Number State | TN
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