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Individual

CHARITY ANGELA LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
104 WEST STATE ST, CARAWAY, AR 72419-8553
(870) 956-0200
(870) 895-2164
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
(870) 856-1202

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1054179
TX
363LF0000X
Family Nurse Practitioner
1054179
TX
363LF0000X
Family Nurse Practitioner
Primary
121536
AR
363LF0000X
Family Nurse Practitioner
26264
TN

Other

Enumeration date
10/08/2019
Last updated
09/23/2025
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