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Organization

OB-GYN OF LANCASTER, INC ADV NURSING PROV

Active
Parent organization
OB-GYN OF LANCASTER, INC
Other names
OB-GYN of Lancaster, Inc
Organization subpart
Yes

Provider details

NPI number
Legal business name
OB-GYN OF LANCASTER, INC
Authorized official
DIANE M STRECK LPN, CAC (CREDENTIALING)
(717) 390-2589
Entity
Organization

Contact information

Practice address
1059 COLUMBIA AVE, LANCASTER, PA 17603-3130
(717) 397-7085
(717) 390-2584
Mailing address
1059 COLUMBIA AVE, LANCASTER, PA 17603-3130
(717) 397-7085
(717) 390-2584

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
UP1001076G
PA
367A00000X
Advanced Practice Midwife
MW008081L
PA
367A00000X
Advanced Practice Midwife
Primary
MW008165L
PA
367A00000X
Advanced Practice Midwife
MW008560L
PA
367A00000X
Advanced Practice Midwife
MW010049
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007423330007
PA
05
102138829
PA
Enumeration date
11/30/2007
Last updated
08/29/2008
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