Individual
JANNA NICOLE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 E 18TH ST, CHESTER, PA 19013-5301
(302) 752-7185
Mailing address
21 E 18TH ST, CHESTER, PA 19013-5301
(302) 752-7185
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
TGPN029136
PA
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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