Provider Demographics
NPI:1649562901
Name:FRIEND-LANTZ, RACHEL RENEE (NP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENEE
Last Name:FRIEND-LANTZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14689 GARRETT HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-4059
Mailing Address - Country:US
Mailing Address - Phone:301-334-5610
Mailing Address - Fax:888-843-8457
Practice Address - Street 1:14689 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-4059
Practice Address - Country:US
Practice Address - Phone:301-334-5610
Practice Address - Fax:888-843-8457
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN68157-NP-C363LF0000X
MDR174165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD221137800Medicaid
WV3810020979Medicaid
MD234114ZFWYMedicare PIN