Provider Demographics
NPI:1598987935
Name:LANCASTER, DEBRA A (IDC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:A
Last Name:LANCASTER
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 1:13201 COMPANION CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-3113
Mailing Address - Country:US
Mailing Address - Phone:904-270-5947
Mailing Address - Fax:904-270-7038
Practice Address - Street 1:13201 COMPANION CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-3113
Practice Address - Country:US
Practice Address - Phone:904-220-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman