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NPI Code Detail

MEDICARE: MS. LANA SMITH VANSTORY MPAS, PA-C

MEDICARE: MS. LANA SMITH VANSTORY MPAS, PA-C
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
1363A00000XPhysician Assistant102748NC

General Provider Information

NPI Number : 1407907181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LANA SMITH VANSTORY MPAS, PA-C
Provider Business Mailing Address
First Line : 1806 GLENDALE DR SW
Second Line :
City : WILSON
State : NC
Zip : 27893-4402
Country : US
Telephone Number : 252-243-0566
Fax Number : 252-243-1347
Provider Business Practice Location Address
First Line : 1806 GLENDALE DR SW
Second Line :
City : WILSON
State : NC
Zip : 27893-4402
Country : US
Telephone Number : 252-243-0566
Fax Number : 252-243-1347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 09/22/2010

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