Provider Demographics
NPI:1386348761
Name:LANTZ, RYAN (RN)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:LANTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-3573
Mailing Address - Country:US
Mailing Address - Phone:850-281-8758
Mailing Address - Fax:
Practice Address - Street 1:7000 COBBLE CRK
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8638
Practice Address - Country:US
Practice Address - Phone:850-473-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9602949163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical