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General NPI Number Information
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NPI Number | 1033341995
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Entity Type | Individual
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Provider Name | DEBRA J LANZA NP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 9200 W WISCONSIN AVE VASCULAR SURGERY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-9160
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Fax | 414-805-9170
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Provider Business Mailing Address
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Address Line | 9200 W WISCONSIN AVE VASCULAR SURGERY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-9160
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Fax | 414-805-9170
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 82844
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License Number State | WI
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