Provider Demographics
NPI:1639315732
Name:LACHMAN, VICKI DIANE (PHD, APRN, MBE)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:DIANE
Last Name:LACHMAN
Suffix:
Gender:F
Credentials:PHD, APRN, MBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 GULF OF MEXICO DR STE 105
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-2048
Mailing Address - Country:US
Mailing Address - Phone:941-238-0266
Mailing Address - Fax:941-244-5505
Practice Address - Street 1:3810 GULF OF MEXICO DR # F107
Practice Address - Street 2:
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-2740
Practice Address - Country:US
Practice Address - Phone:941-238-0266
Practice Address - Fax:941-244-5505
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-20
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007219363LP0808X, 364SP0809X
PARN163230L364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health