Individual
SCOTT ANDERSON LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
9149 W BLACK EAGLE DR, BOISE, ID 83709-1572
(208) 501-3999
Mailing address
9149 W BLACK EAGLE DR, BOISE, ID 83709-1572
(208) 501-3999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95019746
CA
Other
Enumeration date
01/14/2022
Last updated
12/07/2023
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