Individual
MS. JUDY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P., R.N.
Contact information
Practice address
25 MITCHELL BLVD, SUITE 8, SAN RAFAEL, CA 94903-2007
(415) 472-2343
(415) 472-7636
Mailing address
30 MARIN VALLEY DR, NOVATO, CA 94949-6806
(415) 883-3955
(415) 472-7636
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
501901
CA
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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