Individual
DR. NICOLE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
4570 E CACTUS RD, PHOENIX, AZ 85032-7702
(480) 308-7053
Mailing address
4570 E CACTUS RD, PHOENIX, AZ 85032-7702
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S018887
AZ
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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