Provider Demographics
NPI:1699919605
Name:LANUM, DRAGANA
Entity type:Individual
Prefix:
First Name:DRAGANA
Middle Name:
Last Name:LANUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 ALAMEDA AVE
Mailing Address - Street 2:# 2
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4935
Mailing Address - Country:US
Mailing Address - Phone:216-201-9394
Mailing Address - Fax:
Practice Address - Street 1:1610 ALAMEDA AVE
Practice Address - Street 2:# 2
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4935
Practice Address - Country:US
Practice Address - Phone:216-201-9394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH337880163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse