Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1-041820 | AL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 1-041820 | AL |
NPI | 1013196450 |
---|---|
Provider Name | Mrs. Cheryl Anderson Lane |
First Address | Birmingham, AL 35233-1801 |
Second Address | Birmingham, AL 35233-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2007 |
Last Update Date | 02/11/2007 |