Individual
MS. JENNIFER MANTER LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10628 PARK RD, CAROLINAS MEDICAL CENTER-PINEVILLE, CHARLOTTE, NC 28210-8407
(704) 667-1000
(704) 667-0409
Mailing address
6633 SILVER FOX RD, CHARLOTTE, NC 28270-0683
(704) 443-5237
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-254444
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
80491
NC
367500000X
Certified Registered Nurse Anesthetist
NA07357
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052735
—
NC
05
—
AN1023
—
SC
Enumeration date
07/05/2005
Last updated
12/30/2008
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