Basic Information
Provider Information
NPI: 1851964381
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANSKI
FirstName: VICTORIA
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: ACNPC-AG
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MISCHEL
OtherFirstName: VICTORIA
OtherMiddleName: LYNN
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 5
Mailing Information
Address1: 1155 MILL ST
Address2: MC M14
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759825262
FaxNumber: 7759823900
Practice Location
Address1: 1500 EAST 2ND STREET
Address2: SUITE #302
City: RENO
State: NV
PostalCode: 89502
CountryCode: US
TelephoneNumber: 7759825000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/22/2021
LastUpdateDate: 10/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X842515NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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