Individual
MRS. BRANDI LYNN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3394 N FUTRALL DR STE 2, FAYETTEVILLE, AR 72703-3937
(918) 527-4824
(866) 635-3634
Mailing address
2024 SHORES AVE, CAVE SPRINGS, AR 72718-8434
(918) 527-4824
(866) 635-3634
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0085276
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
C002958
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200130410A
—
OK
Enumeration date
01/10/2008
Last updated
11/30/2015
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