Provider Demographics
NPI:1174570170
Name:KAISER, LANA LOUISE (DC)
Entity type:Individual
Prefix:DR
First Name:LANA
Middle Name:LOUISE
Last Name:KAISER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E US HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2654
Mailing Address - Country:US
Mailing Address - Phone:219-864-7967
Mailing Address - Fax:844-674-1539
Practice Address - Street 1:322 E US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2654
Practice Address - Country:US
Practice Address - Phone:219-864-7967
Practice Address - Fax:219-864-8142
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100201010AMedicaid
IN625700Medicare ID - Type Unspecified