Individual
CAROLYN GRANT LANE
Active
Individual
CAROLYN GRANT LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0014393
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
L6-0A00205
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046452
AANA NUMBER
DE
Enumeration date
09/20/2005
Last updated
02/12/2013
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