NPI | 1477997575 |
---|---|
Former Name | JANETTE MARIE LANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201391435NP-PP) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 089003148RN) | |
Enumeration Date | 2013-04-19 |
Last Update Date | 2014-05-21 |