Provider Demographics
NPI:1700966033
Name:MEARS, LANA (APN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:MEARS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 HOLIDAY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72335-9183
Mailing Address - Country:US
Mailing Address - Phone:870-633-0091
Mailing Address - Fax:870-633-5933
Practice Address - Street 1:902 HOLIDAY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-9183
Practice Address - Country:US
Practice Address - Phone:870-633-0091
Practice Address - Fax:870-633-5933
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01938 ANP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR129735729Medicaid
ARA01938 ANPOtherLICENSE
AR129734729Medicaid
AR100907002Medicaid
AR136428729Medicaid
AR043489Medicare Oscar/Certification
AR043480Medicare Oscar/Certification
AR043492Medicare Oscar/Certification
AR043456Medicare Oscar/Certification
AR129735729Medicaid
AR129734729Medicaid
AR040072Medicare Oscar/Certification