Provider Demographics
NPI:1588734982
Name:LANEY, LORNA LYN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:LORNA
Middle Name:LYN
Last Name:LANEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33205 TEMECULA PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-9142
Mailing Address - Country:US
Mailing Address - Phone:951-303-3164
Mailing Address - Fax:
Practice Address - Street 1:33205 TEMECULA PKWY
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-9142
Practice Address - Country:US
Practice Address - Phone:951-303-3164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP4629363LF0000X
CA4629363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0050580Medicaid
CAS15310Medicare UPIN
CABJ116ZMedicare PIN
CABJ116WMedicare PIN