Individual
MRS. LANIE M KONCILJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
55 ARCH ST STE 1B, AKRON, OH 44304-1436
(330) 375-3315
Mailing address
55 ARCH ST STE 1B, AKRON, OH 44304-1436
(330) 375-3315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
APRN.CNP.023865
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94-3069757
PPO
CA
Enumeration date
02/07/2018
Last updated
12/20/2019
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