Provider Demographics
NPI:1508552670
Name:LANE, BRITTA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:BRITTA
Middle Name:K
Last Name:LANE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 E ROYAL PALM SQ S
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3638
Mailing Address - Country:US
Mailing Address - Phone:602-717-3996
Mailing Address - Fax:
Practice Address - Street 1:618 E ROYAL PALM SQ S
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3638
Practice Address - Country:US
Practice Address - Phone:602-717-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP290443363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care