Basic Information
Provider Information
NPI: 1962583534
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARNS
FirstName: LANCE
MiddleName: ROGER
NamePrefix:  
NameSuffix:  
Credential: ARNP, NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2586
Address2:  
City: SPOKANE
State: WA
PostalCode: 992202586
CountryCode: US
TelephoneNumber: 5098680876
FaxNumber: 5093850670
Practice Location
Address1: 105 W 8TH AVE STE 150E
Address2:  
City: SPOKANE
State: WA
PostalCode: 992042302
CountryCode: US
TelephoneNumber: 5094653919
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 10/18/2006
LastUpdateDate: 10/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP30006103WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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