=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659952646
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY NICOLE LANIER D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2021
-----------------------------------------------------
Last Update Date | 07/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3608 MEDICAL PARK CT
-----------------------------------------------------
City | MOREHEAD CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28557-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-247-3476
-----------------------------------------------------
Fax | 252-247-3478
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3608 MEDICAL PARK CT
-----------------------------------------------------
City | MOREHEAD CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28557-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-247-3476
-----------------------------------------------------
Fax | 252-247-3478
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 2024-00385
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------