Individual
ERICA LANKENAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
630 W MAPLE ST, FARMINGTON, NM 87401-6113
(505) 609-6300
(505) 609-6301
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1130229
NM
363AS0400X
Surgical Physician Assistant
Primary
PA2015-0082
NM
Other
Enumeration date
12/31/2015
Last updated
07/20/2016
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