Healthcare Provider Details

I. General information

NPI: 1457418907
Provider Name (Legal Business Name): CHARLES LEWIS LAMBERT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/23/2020
Certification Date: 03/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AIRPORT RD
KINSTON NC
28501-1604
US

IV. Provider business mailing address

PO BOX 1851
MANTEO NC
27954-1851
US

V. Phone/Fax

Practice location:
  • Phone: 252-522-7000
  • Fax:
Mailing address:
  • Phone: 252-240-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number137030
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: