Provider Demographics
NPI:1801842521
Name:LANSING, ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:LANSING
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 1:508 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-6108
Mailing Address - Country:US
Mailing Address - Phone:406-544-7249
Mailing Address - Fax:
Practice Address - Street 1:508 MONROE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-6108
Practice Address - Country:US
Practice Address - Phone:406-544-7249
Practice Address - Fax:406-444-2389
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT14860367500000X
CA3397367500000X
CA351987163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicaid
CAPENDINGMedicaid