Provider Demographics
NPI:1508834029
Name:CLOUSER, LANA RAE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:RAE
Last Name:CLOUSER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 CRESTLAND DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5733
Mailing Address - Country:US
Mailing Address - Phone:757-362-6180
Mailing Address - Fax:
Practice Address - Street 1:25150 HANCOCK AVE STE 208
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5989
Practice Address - Country:US
Practice Address - Phone:951-698-8805
Practice Address - Fax:951-698-8898
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI054262367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered