Provider Demographics
NPI:1255085361
Name:LANICH, BRITTANY NOELLE (CRNP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NOELLE
Last Name:LANICH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 WOODEL RD
Mailing Address - Street 2:
Mailing Address - City:GRAMPIAN
Mailing Address - State:PA
Mailing Address - Zip Code:16838-9052
Mailing Address - Country:US
Mailing Address - Phone:814-553-4112
Mailing Address - Fax:
Practice Address - Street 1:621 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1413
Practice Address - Country:US
Practice Address - Phone:814-229-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025335363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner