Provider Demographics
NPI:1447648209
Name:LANTZ, ALLISON (CNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LANTZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-399-4243
Mailing Address - Fax:330-399-8716
Practice Address - Street 1:661 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-4607
Practice Address - Country:US
Practice Address - Phone:330-399-4243
Practice Address - Fax:330-399-8716
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16689-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner