Provider Demographics
NPI:1174815690
Name:LANE, ELISABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W. 7TH AVENUE RM. 210
Mailing Address - Street 2:LANE COUNTY PUBLIC HEALTH
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2676
Mailing Address - Country:US
Mailing Address - Phone:541-682-3913
Mailing Address - Fax:541-682-3925
Practice Address - Street 1:151 W. 7TH AVENUE RM 210
Practice Address - Street 2:LANE COUNTY PUBLIC HEALTH
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2676
Practice Address - Country:US
Practice Address - Phone:541-682-3913
Practice Address - Fax:541-682-3925
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR098007249RN163WC0400X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn