Provider Demographics
NPI:1598109902
Name:NEALAND, LANA NADINE (CRNP)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:NADINE
Last Name:NEALAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2341
Mailing Address - Country:US
Mailing Address - Phone:205-358-3589
Mailing Address - Fax:
Practice Address - Street 1:3801 COMPUTER DR
Practice Address - Street 2:STE 103A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6506
Practice Address - Country:US
Practice Address - Phone:919-420-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC119106163WW0000X
NC5006192363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health