Provider Demographics
NPI:1720325400
Name:ADVANCE PRACTICE NURSING, INC
Entity Type:Organization
Organization Name:ADVANCE PRACTICE NURSING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WEGENER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-PA
Authorized Official - Phone:727-505-4519
Mailing Address - Street 1:7064 SAN LUCAS CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3600
Mailing Address - Country:US
Mailing Address - Phone:727-505-4519
Mailing Address - Fax:727-726-7800
Practice Address - Street 1:7064 SAN LUCAS CT
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-3600
Practice Address - Country:US
Practice Address - Phone:727-505-4519
Practice Address - Fax:727-726-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1062972363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty