| NPI | 1588638589 |
|---|---|
| Former Name | NANCY JO LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704218106) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704218106) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2012-11-19 |