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Individual

KAREN ELIZABETH LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP-BC

Contact information

Practice address
730 GLYNN ST S, FAYETTEVILLE, GA 30214-2050
(770) 460-3650
Mailing address
PO BOX 850001, ORLANDO, FL 32885-0394
(904) 282-6331
(904) 282-1550

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2084672
FL
363LF0000X
Family Nurse Practitioner
Primary
RN145860
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001441400
FL
Enumeration date
08/08/2009
Last updated
04/20/2022
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