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Individual
KELLY A LANE
Active
Individual
KELLY A LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-005706
IL
363LF0000X
Family Nurse Practitioner
Primary
ARNP9315463
FL
Other
Enumeration date
06/27/2006
Last updated
07/21/2022
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