Healthcare Provider Details

I. General information

NPI: 1811965163
Provider Name (Legal Business Name): KAROL ANN LANCASTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: KAROL ANN BAKER RN

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER ATTN: MCHJ-PV/C (ANN LANCASTER)
TACOMA WA
98431-0001
US

IV. Provider business mailing address

8604 26TH ST W # 126
UNIVERSITY PLACE WA
98466-8281
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-4388
  • Fax: 253-968-4389
Mailing address:
  • Phone: 253-565-2557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN00096844
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: