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NPI Code Detail

MEDICARE: MS. JENNIFER MANTER LANCASTER CRNA

MEDICARE: MS. JENNIFER MANTER LANCASTER CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN-254444OH
2367500000XCertified Registered Nurse AnesthetistNA07357OH
3367500000XCertified Registered Nurse Anesthetist80491NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801893839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER MANTER LANCASTER CRNA
Provider Business Mailing Address
First Line : 6633 SILVER FOX RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-0683
Country : US
Telephone Number : 704-443-5237
Fax Number :
Provider Business Practice Location Address
First Line : 10628 PARK RD
Second Line : CAROLINAS MEDICAL CENTER-PINEVILLE
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 704-667-1000
Fax Number : 704-667-0409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 12/30/2008

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