Provider Demographics
NPI:1134892813
Name:ZANE, KACEY LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:KACEY
Middle Name:LYNN
Last Name:ZANE
Suffix:
Gender:
Credentials:RN
Other - Prefix:MISS
Other - First Name:KACEY
Other - Middle Name:LYNN
Other - Last Name:BOHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224-D CORNWALL STREET, NW, STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG, VA
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:24430 STONE SPRINGS BLVD., SUITE 475
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2272
Practice Address - Country:US
Practice Address - Phone:703-957-1245
Practice Address - Fax:703-665-2374
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192723363LW0102X, 367A00000X
HIRN-82556163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty