Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | ARNP2237492 | FL |
NPI | 1043341076 |
---|---|
Provider Name | Ms. Ann Elizabeth Lane |
First Address | High Springs, FL 32643-1245 |
Second Address | High Springs, FL 32643-1245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 09/07/2007 |