Provider Demographics
NPI:1194851451
Name:LANZA, MARILYN LEWIS (DNSC, ARNP, CS, FAAN)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:LEWIS
Last Name:LANZA
Suffix:
Gender:F
Credentials:DNSC, ARNP, CS, FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1139
Mailing Address - Country:US
Mailing Address - Phone:603-432-8680
Mailing Address - Fax:781-687-3337
Practice Address - Street 1:44 E NASHUA RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1139
Practice Address - Country:US
Practice Address - Phone:603-432-8680
Practice Address - Fax:781-687-3337
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH014673-23-08163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult