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Individual
MS. ROBERTA S LANE
Active
Individual
MS. ROBERTA S LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
29697
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300046
NC BON PRESCRIBING NUMBER
NC
01
—
78259
PED NURSING CERTIFICATION
NC
Enumeration date
12/21/2006
Last updated
03/20/2013
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