Provider Demographics
NPI:1063827129
Name:LANCASTER, DIANE SUSAN (RN)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:SUSAN
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-1822
Mailing Address - Country:US
Mailing Address - Phone:251-287-8420
Mailing Address - Fax:251-287-8478
Practice Address - Street 1:2900 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-1822
Practice Address - Country:US
Practice Address - Phone:251-287-8420
Practice Address - Fax:251-287-8478
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101513163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator