Provider Demographics
NPI:1831103647
Name:LANE, MEGAN E (FNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:LANE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LEIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2225
Mailing Address - Country:US
Mailing Address - Phone:207-878-8799
Mailing Address - Fax:207-878-8797
Practice Address - Street 1:66 LEIGHTON RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2225
Practice Address - Country:US
Practice Address - Phone:207-878-8799
Practice Address - Fax:207-878-8797
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEAP081320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEQ05642Medicare UPIN
MENP436701Medicare PIN
ME265480099Medicare ID - Type Unspecified
MENP4367Medicare ID - Type Unspecified