Provider Information for 1356976369
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OLIVIA LANIER
Sex: Female
NPI: 1356976369
Last Updated: 2024-12-16
Certification Date: 2024-12-16
Certification Date: 2024-12-16
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1356976369 | ||||||||
| Enumeration Date | 2020-03-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2543 CLAY ST PADUCAH, KY 42001-3715 United States Phone: 270-442-7121 | Fax: | ||||||||
| Primary Practice Address | 2543 CLAY ST PADUCAH, KY 42001-3715 United States Phone: 270-442-7121 | Fax: | ||||||||
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