Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 5342 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 5342 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5342 | TN |
NPI | 1417913674 |
---|---|
Provider Name | Ms. Cathy S Lane |
First Address | Memphis, TN 38103-2807 |
Second Address | Memphis, TN 38103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3341196 | (05) | TN |
S75379 | (02) |