Provider Demographics
NPI:1588144596
Name:THORN, LANEY BEISER (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:LANEY
Middle Name:BEISER
Last Name:THORN
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:LANEY
Other - Middle Name:BEISER
Other - Last Name:BECKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:825 N MAIN ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-2100
Mailing Address - Country:US
Mailing Address - Phone:937-762-5000
Mailing Address - Fax:937-522-9824
Practice Address - Street 1:825 N MAIN ST STE 140
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-2100
Practice Address - Country:US
Practice Address - Phone:937-762-5030
Practice Address - Fax:937-762-5039
Is Sole Proprietor?:No
Enumeration Date:2018-08-19
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily