Provider Demographics
NPI:1417394719
Name:LANIER, ANITA (OMD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:LANIER
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W HORIZON RIDGE PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2637
Mailing Address - Country:US
Mailing Address - Phone:702-204-1342
Mailing Address - Fax:877-992-4441
Practice Address - Street 1:2200 W HORIZON RIDGE PKWY STE D
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2637
Practice Address - Country:US
Practice Address - Phone:702-204-1342
Practice Address - Fax:877-992-4441
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15091171100000X
NV1040171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist