Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 20706 | NE |
NPI | 1831136043 |
---|---|
Provider Name | Pascale H Lane |
First Address | Oklahoma City, OK 73104-4637 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 26/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47078557563 | (05) | NE |
E96144 | (02) | NE |