Michael Dale Lance II, CRNA
Nurse Anesthetist, Certified Registered in Louisville, KY. Individual provider (NPI-1).
NPI number1063032001
StatusActive
Last updated in NPPESAug 5, 2020
Details
- NPI
- 1063032001
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Dale Lance II
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 20, 2020
- Certification date
- Aug 5, 2020
- Last updated
- Aug 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 3014694 | KY | Yes |
Practice location
530 S Jackson StLouisville, KY 40202-1675
Phone 502-852-1735 · Fax 502-852-6056
Mailing address
Po Box 909Louisville, KY 40201-0909
Phone 502-588-0328 · Fax 502-587-4784
Other practice locations
200 Abraham Flexner Way
Louisville, KY 40202-2877
Louisville, KY 40202-2877
Phone 502-587-4044 · Fax 502-587-4156
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