Provider Demographics
NPI:1225722127
Name:LANE, WILLIAM KRISTOPHER (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KRISTOPHER
Last Name:LANE
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 DORCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-8306
Mailing Address - Country:US
Mailing Address - Phone:615-969-3134
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2020
Practice Address - Country:US
Practice Address - Phone:615-964-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34100363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care