Provider Demographics
NPI:1497088553
Name:LANE, CAYCI DENISE (NP)
Entity Type:Individual
Prefix:
First Name:CAYCI
Middle Name:DENISE
Last Name:LANE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4005 FOUNTAIN VALLEY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-5327
Mailing Address - Country:US
Mailing Address - Phone:865-223-6561
Mailing Address - Fax:
Practice Address - Street 1:4005 FOUNTAIN VALLEY DR
Practice Address - Street 2:SUITE 150
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-5327
Practice Address - Country:US
Practice Address - Phone:865-223-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000170691163W00000X
TNAPN0000015652363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse