Provider Demographics
NPI:1326582297
Name:HUSONG, LANA (LPN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:HUSONG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:
Other - Last Name:SIZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:859 E MELTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:OK
Mailing Address - Zip Code:74346
Mailing Address - Country:US
Mailing Address - Phone:918-253-1700
Mailing Address - Fax:918-253-6822
Practice Address - Street 1:859 E MELTON DRIVE
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:OK
Practice Address - Zip Code:74346
Practice Address - Country:US
Practice Address - Phone:918-253-1700
Practice Address - Fax:918-253-6822
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41686164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse