Provider Demographics
NPI:1902355563
Name:OMOROJI, LANA (LVN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:OMOROJI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71386
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93387-1386
Mailing Address - Country:US
Mailing Address - Phone:661-240-3537
Mailing Address - Fax:
Practice Address - Street 1:2813 OCCIDENTAL ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-2326
Practice Address - Country:US
Practice Address - Phone:661-240-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134875164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse