Provider Demographics
NPI:1598490435
Name:LANE, FLOR ERIKA
Entity Type:Individual
Prefix:
First Name:FLOR
Middle Name:ERIKA
Last Name:LANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81580 MINNOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97452-9741
Mailing Address - Country:US
Mailing Address - Phone:541-852-2890
Mailing Address - Fax:
Practice Address - Street 1:1075 IRVINGTON DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-4019
Practice Address - Country:US
Practice Address - Phone:541-607-8587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202109872LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR202109872LPNOtherOSNB