Provider Demographics
NPI:1336014489
Name:HEMPHILL, LANIACIN BLAYNE
Entity type:Individual
Prefix:
First Name:LANIACIN
Middle Name:BLAYNE
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3664 PINEY RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-6647
Mailing Address - Country:US
Mailing Address - Phone:828-616-0183
Mailing Address - Fax:
Practice Address - Street 1:3664 PINEY RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-6647
Practice Address - Country:US
Practice Address - Phone:828-616-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver