Provider Demographics
NPI:1215644646
Name:LANZ, SARA (RN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LANZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4393 KEVIN WALKER DR # 176
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1636
Mailing Address - Country:US
Mailing Address - Phone:703-232-5672
Mailing Address - Fax:703-232-1066
Practice Address - Street 1:15349 WITS END DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5890
Practice Address - Country:US
Practice Address - Phone:703-232-5672
Practice Address - Fax:703-232-1066
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0001145395163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy