Provider Demographics
NPI:1336275957
Name:LANSING, JOSEPH MICHAEL (LVN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:LANSING
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NOLANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76559-4647
Mailing Address - Country:US
Mailing Address - Phone:254-698-6391
Mailing Address - Fax:
Practice Address - Street 1:303 OAK RIDGE DR
Practice Address - Street 2:
Practice Address - City:NOLANVILLE
Practice Address - State:TX
Practice Address - Zip Code:76559-4647
Practice Address - Country:US
Practice Address - Phone:254-698-6391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167000164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse