Provider Demographics
NPI:1841240587
Name:LANEN, SUSAN M KLOSS (MSN, RN, GNP-BC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M KLOSS
Last Name:LANEN
Suffix:
Gender:F
Credentials:MSN, RN, GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:160 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1508
Mailing Address - Country:US
Mailing Address - Phone:978-562-3117
Mailing Address - Fax:
Practice Address - Street 1:810 VERMONT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-0001
Practice Address - Country:US
Practice Address - Phone:202-461-6049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER039620163W00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology