Individual
MS. MARIE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
480 OCEAN PKWY, BOYNTON BEACH, FL 33435-1849
(561) 859-5051
Mailing address
480 OCEAN PARKWAY, BOYNTON BEACH, FL 33435-1849
(561) 859-5051
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN5153244
FL
373H00000X
Day Training/Habilitation Specialist
PN5153244
FL
Other
Enumeration date
08/28/2016
Last updated
05/24/2021
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