Provider Demographics
NPI:1568732303
Name:LANCE, MAGGIE BROWN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:BROWN
Last Name:LANCE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:4064 POSTAL DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6438
Mailing Address - Country:US
Mailing Address - Phone:540-283-6000
Mailing Address - Fax:540-342-2745
Practice Address - Street 1:4064 POSTAL DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6438
Practice Address - Country:US
Practice Address - Phone:540-283-6000
Practice Address - Fax:540-342-2745
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-003757363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant