Provider Demographics
NPI:1568604577
Name:LANE, MARSHA LOUISE (NURSE)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:LOUISE
Last Name:LANE
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 ROBERT QUIGLEY DR
Mailing Address - Street 2:# 2
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546-1036
Mailing Address - Country:US
Mailing Address - Phone:585-889-3111
Mailing Address - Fax:
Practice Address - Street 1:303 ROBERT QUIGLEY DR
Practice Address - Street 2:# 2
Practice Address - City:SCOTTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14546-1036
Practice Address - Country:US
Practice Address - Phone:585-889-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293249-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse