Provider Demographics
NPI:1104866268
Name:LANE, CHRISTINE ANN (MFT, RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:LANE
Suffix:
Gender:F
Credentials:MFT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 MAYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-7128
Mailing Address - Country:US
Mailing Address - Phone:775-352-9365
Mailing Address - Fax:775-787-9205
Practice Address - Street 1:80 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3431
Practice Address - Country:US
Practice Address - Phone:775-324-3300
Practice Address - Fax:775-324-3382
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0703106H00000X
NV22143163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse