Provider Demographics
NPI:1710914353
Name:LANTER, ANGELA D (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:LANTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:TOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:3084 LAKECREST CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1706
Mailing Address - Country:US
Mailing Address - Phone:859-219-6440
Mailing Address - Fax:859-219-6449
Practice Address - Street 1:3084 LAKECREST CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1706
Practice Address - Country:US
Practice Address - Phone:859-219-6440
Practice Address - Fax:859-219-6449
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004107363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78013323Medicaid
KY78013323Medicaid
KYQ07705Medicare UPIN
KYK050140Medicare PIN