Individual
LISA ANN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
ONE FREEDOM WAY, AUGUSTA, GA 30904
(706) 733-0188
Mailing address
523 HILLCREST DR, NORTH AUGUSTA, SC 29841-4414
(803) 278-4984
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R226547
SC
163W00000X
Registered Nurse
Primary
RN205915
GA
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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