Provider Demographics
NPI:1730292962
Name:LANE, BARBARA (RNCNPMSN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:RNCNPMSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N DAL PASO
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:575-964-8550
Mailing Address - Fax:575-393-0319
Practice Address - Street 1:1900 N DAL PASO ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-3045
Practice Address - Country:US
Practice Address - Phone:575-964-8550
Practice Address - Fax:575-393-0319
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP00343363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1730392962OtherGROUP NPI
NM00098338Medicaid
NM00NM006D38OtherBCBS
NM00098338Medicaid
NMR01498Medicare UPIN
NM1306391107Medicare PIN