Provider Demographics
NPI:1801247689
Name:LANIER, CHASITIY A (EFDA)
Entity type:Individual
Prefix:
First Name:CHASITIY
Middle Name:A
Last Name:LANIER
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431
Mailing Address - Street 2:68TH ST
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4431 68TH ST
Practice Address - Street 2:US ARMY DENTAL ACTIVITY
Practice Address - City:FT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant