Provider Demographics
NPI:1073708806
Name:LANIER, KATE (OD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:LANIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12105 COPPER WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1756
Mailing Address - Country:US
Mailing Address - Phone:704-295-4444
Mailing Address - Fax:
Practice Address - Street 1:8320 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1338
Practice Address - Country:US
Practice Address - Phone:704-295-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2063152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist