Provider Demographics
NPI:1891367561
Name:LANE, ARLENE KATINA
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:KATINA
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 1:11 HINKLE DR
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2417
Mailing Address - Country:US
Mailing Address - Phone:304-517-3841
Mailing Address - Fax:
Practice Address - Street 1:11 HINKLE DR
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2417
Practice Address - Country:US
Practice Address - Phone:304-517-3841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant