Provider Demographics
NPI:1386519908
Name:LANE, KATHY BURDICK (PT)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:BURDICK
Last Name:LANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4528 HORSESHOE TRL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-8030
Mailing Address - Country:US
Mailing Address - Phone:865-318-5304
Mailing Address - Fax:
Practice Address - Street 1:407 LAURA LEE DR
Practice Address - Street 2:
Practice Address - City:WHITE PINE
Practice Address - State:TN
Practice Address - Zip Code:37890-3500
Practice Address - Country:US
Practice Address - Phone:865-327-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9922251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics