Individual
RONNIKA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 COMPTON AVE, SAINT LOUIS, MO 63135-2732
(314) 363-6826
Mailing address
24 COMPTON AVE, SAINT LOUIS, MO 63135-2732
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
844069755
—
MO
Enumeration date
12/23/2019
Last updated
12/23/2019
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