Provider Demographics
NPI:1497050793
Name:LEHNER, DOREEN E (IDC)
Entity Type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:E
Last Name:LEHNER
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL TREATMENT FACILITY
Mailing Address - Street 2:USNS MERCY T-AH 19
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96672-4090
Mailing Address - Country:US
Mailing Address - Phone:619-767-6226
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL TREATMENT FACILITY
Practice Address - Street 2:USNS MERCY T AH 19
Practice Address - City:FPO AP
Practice Address - State:CA
Practice Address - Zip Code:96672-4090
Practice Address - Country:US
Practice Address - Phone:619-767-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman