Provider Demographics
NPI:1922629781
Name:MERRITT, LANA L (RN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:L
Last Name:MERRITT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ELMER ST
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:NY
Mailing Address - Zip Code:14489-1305
Mailing Address - Country:US
Mailing Address - Phone:585-721-8175
Mailing Address - Fax:
Practice Address - Street 1:19 ELMER ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NY
Practice Address - Zip Code:14489-1305
Practice Address - Country:US
Practice Address - Phone:585-721-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY639598163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice