Provider Demographics
NPI:1194715821
Name:LANTZ, RONDA LEA (RN,FNP)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:LEA
Last Name:LANTZ
Suffix:
Gender:F
Credentials:RN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1290 COUNTY ROAD 2615
Mailing Address - Street 2:
Mailing Address - City:RIO MEDINA
Mailing Address - State:TX
Mailing Address - Zip Code:78066-2606
Mailing Address - Country:US
Mailing Address - Phone:830-931-3222
Mailing Address - Fax:830-931-3222
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE-QD/CREDENTIALS
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-3000
Practice Address - Fax:210-916-5156
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily