Provider Demographics
NPI:1497221097
Name:ELLER, LANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:
Last Name:ELLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 ROYAL TROON CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-5519
Mailing Address - Country:US
Mailing Address - Phone:864-320-1421
Mailing Address - Fax:
Practice Address - Street 1:1640 ROYAL TROON CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-5519
Practice Address - Country:US
Practice Address - Phone:864-320-1421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF07181356F363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care