Provider Demographics
NPI:1326293960
Name:PURSER, LANE (RN)
Entity Type:Individual
Prefix:MR
First Name:LANE
Middle Name:
Last Name:PURSER
Suffix:
Gender:M
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:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:KLAWOCK
Mailing Address - State:AK
Mailing Address - Zip Code:99925
Mailing Address - Country:US
Mailing Address - Phone:907-755-4800
Mailing Address - Fax:907-755-4981
Practice Address - Street 1:7300 KLAWOCK-HOLLIS HWY
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925
Practice Address - Country:US
Practice Address - Phone:907-755-4800
Practice Address - Fax:907-755-4908
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK28736163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse