Individual
AUDREY LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1500 W ELK AVE, ELIZABETHTON, TN 37643-2654
(423) 929-2584
(423) 722-2060
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 929-2584
(423) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
17611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17611
APN LICENSE
TN
Enumeration date
05/02/2013
Last updated
05/02/2013
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