Provider Demographics
NPI:1255486650
Name:BUCHANAN, LANIKA M (ND, AP)
Entity Type:Individual
Prefix:
First Name:LANIKA
Middle Name:M
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:ND, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4449 SAXON DR
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-4136
Mailing Address - Country:US
Mailing Address - Phone:386-847-9797
Mailing Address - Fax:
Practice Address - Street 1:5656 ISABELLE AVE STE 6
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-6255
Practice Address - Country:US
Practice Address - Phone:386-847-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171100000X171100000X
WANT00000995175F00000X
FL4267171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath