Provider Demographics
NPI:1144876103
Name:LANNING, MICHELLE RENEE (NP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:LANNING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3559
Mailing Address - Country:US
Mailing Address - Phone:320-631-7000
Mailing Address - Fax:320-631-7079
Practice Address - Street 1:811 2ND ST SE STE A
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3558
Practice Address - Country:US
Practice Address - Phone:320-631-7000
Practice Address - Fax:320-631-7079
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6829OtherMN BOARD OF NURSING
F06192543OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD