Individual
SARAH MARIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14500 99TH AVE N, MAPLE GROVE, MN 55369-4730
(763) 898-1000
(763) 898-1009
Mailing address
13909 W WAINWRIGHT DR, BOISE, ID 83713-1969
(208) 389-2213
(208) 389-4659
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1030
ID
Other
Enumeration date
09/13/2007
Last updated
11/10/2022
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