Individual
PATRICIA E LANE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
825 MEDICAL DR, TYLER, TX 75701-2143
(903) 597-2273
(903) 597-2466
Mailing address
825 MEDICAL DR, TYLER, TX 75701-2143
(903) 597-2273
(903) 597-2466
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
695551
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1608259
—
TX
Enumeration date
06/30/2005
Last updated
07/08/2007
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