Provider Demographics
NPI:1659793248
Name:LANNING-HART, MELISSA ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:LANNING-HART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:LANNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1926 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1508
Mailing Address - Country:US
Mailing Address - Phone:610-621-0014
Mailing Address - Fax:
Practice Address - Street 1:1926 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1508
Practice Address - Country:US
Practice Address - Phone:610-621-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013600363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics