BRUCE RANDALL LANUM RN MN CS FNP NPI 1205925120

NPI Information

NPI: 1205925120
Provider Name: BRUCE RANDALL LANUM, RN, MN, CS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
4401 BRIDGEPORT WAY W
ATTN CREDENTIALING
UNIVERSITY PLACE, WA
ZIP 98466
Phone: (253) 564-4157
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Bruce Randall Lanum, RN, MN, CS, FNP is a family nurse practitioner in University Place, WA. Bruce Randall Lanum, RN, MN, CS, FNP NPI is 1205925120. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4401 BRIDGEPORT WAY W
ATTN CREDENTIALING
UNIVERSITY PLACE, WA
ZIP 98466-201
Phone: (253) 564-4157
Fax: (253) 564-4813

The enumeration date for this NPI number is 10/11/2006 and was last updated on 2/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP60060142	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	VAD 000	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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