Provider Demographics
NPI:1144208620
Name:LANNING, VIRGINIA RUTH (FNP)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:RUTH
Last Name:LANNING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1790
Mailing Address - Street 2:
Mailing Address - City:BUCKSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04416-1790
Mailing Address - Country:US
Mailing Address - Phone:207-469-6880
Mailing Address - Fax:207-469-3766
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416
Practice Address - Country:US
Practice Address - Phone:207-469-6880
Practice Address - Fax:207-469-3766
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME549460Medicare PIN
MENP0902Medicare PIN
MENP090201Medicare PIN