Provider Demographics
NPI:1972349124
Name:LANEAU, KERRI PLATT
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:PLATT
Last Name:LANEAU
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 1:41 ALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-5153
Mailing Address - Country:US
Mailing Address - Phone:781-718-3654
Mailing Address - Fax:
Practice Address - Street 1:41 ALVIN AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-5153
Practice Address - Country:US
Practice Address - Phone:781-718-3654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist