Provider Demographics
NPI:1740728898
Name:LANE, JOELLEN (RN)
Entity type:Individual
Prefix:
First Name:JOELLEN
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SCHOOL ST SW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2774
Mailing Address - Country:US
Mailing Address - Phone:202-955-8355
Mailing Address - Fax:202-587-1395
Practice Address - Street 1:501 SCHOOL ST SW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2774
Practice Address - Country:US
Practice Address - Phone:202-955-8355
Practice Address - Fax:202-587-1395
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1042199163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator