Individual
KERRY H LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3 MAHONEY AVE, RUTLAND, VT 05701-4837
(802) 773-3553
(802) 773-3845
Mailing address
3 MAHONEY AVE, RUTLAND, VT 05701-4837
(802) 773-3553
(802) 773-3845
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
101-0012379
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0NP3756
—
VT
01
—
369303
MVP
—
01
—
58658
BCBS
VT
Enumeration date
07/24/2006
Last updated
05/16/2011
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