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General NPI Number Information
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NPI Number | 1700355781
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Entity Type | Individual
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Provider Name | ASHLEY LANCASTER
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Gender | Female
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 1400 8TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4110
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Country | US
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Telephone | 817-926-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 PLAYERS LOOP
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City | SHREVEPORT
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State | LA
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Zip | 71107-3542
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Country | US
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Telephone | 318-503-4071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 947776
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP140284
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License Number State | TX
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