Provider Demographics
NPI:1679281869
Name:SPANDLEY, LANA (PHARMD)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:SPANDLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3704
Mailing Address - Country:US
Mailing Address - Phone:918-299-2684
Mailing Address - Fax:
Practice Address - Street 1:446 S ELM ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3704
Practice Address - Country:US
Practice Address - Phone:918-299-2684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK19638OtherPHARMACIST LICENSE NUMBER