MEDICARE: ANN M. LANSING RN, CARN-AP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	10683-5	MN

General Provider Information

NPI Number	:	1316039167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN M. LANSING RN, CARN-AP

Provider Business Mailing Address
First Line	:	602 11TH AVE NW
Second Line	:	SUITE 300
City	:	ROCHESTER
State	:	MN
Zip	:	55901-1805
Country	:	US
Telephone Number	:	507-292-1379
Fax Number	:	507-289-4524

Provider Business Practice Location Address
First Line	:	602 11TH AVE NW
Second Line	:	SUITE 300
City	:	ROCHESTER
State	:	MN
Zip	:	55901-1805
Country	:	US
Telephone Number	:	507-292-1379
Fax Number	:	507-289-4524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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