Provider Demographics
NPI:1750838983
Name:LANCE, MISTY (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:
Last Name:LANCE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 BELL ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4142
Mailing Address - Country:US
Mailing Address - Phone:806-379-9225
Mailing Address - Fax:
Practice Address - Street 1:3440 BELL ST
Practice Address - Street 2:SUITE 122
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4142
Practice Address - Country:US
Practice Address - Phone:806-379-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily