Provider Demographics
NPI:1932274545
Name:LANEY-COLLIER, WANDA (NP)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:LANEY-COLLIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4519 WOODRUFF RD
Mailing Address - Street 2:PMB 349 SUITE 4
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6011
Mailing Address - Country:US
Mailing Address - Phone:706-653-2255
Mailing Address - Fax:706-653-2329
Practice Address - Street 1:2737 WARM SPRINGS RD
Practice Address - Street 2:SUIT B-C
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6859
Practice Address - Country:US
Practice Address - Phone:706-653-2255
Practice Address - Fax:706-653-2329
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN098539363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner