Provider Demographics
NPI:1073531810
Name:LANIER, MARCIA B (APRN)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:B
Last Name:LANIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 PROFESSIONAL PARK CIR STE 80
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4536
Mailing Address - Country:US
Mailing Address - Phone:850-402-5454
Mailing Address - Fax:850-402-5454
Practice Address - Street 1:1881 PROFESSIONAL PARK CIR STE 80
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4536
Practice Address - Country:US
Practice Address - Phone:850-402-5454
Practice Address - Fax:850-402-5454
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2751672363LP0200X
FLAPRN2751672363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics