Provider Demographics
NPI:1457520819
Name:LANE, PATRICIA (RN PHD SNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:RN PHD SNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 SIMON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-6427
Mailing Address - Country:US
Mailing Address - Phone:504-737-5523
Mailing Address - Fax:504-737-2649
Practice Address - Street 1:8101 SIMON ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-6427
Practice Address - Country:US
Practice Address - Phone:504-737-5523
Practice Address - Fax:504-737-2649
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA041019163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health