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Individual

MRS. PAMELA J LANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-8630
(774) 441-6710
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-8105

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN277615
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN277615
MA
363LF0000X
Family Nurse Practitioner
277615
MA

Other

Enumeration date
04/05/2013
Last updated
10/31/2022
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