Individual
LANE TYLER YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 RAVENHILL DR, ATCHISON, KS 66002-9204
(913) 367-2131
Mailing address
800 RAVENHILL DR, ATCHISON, KS 66002-9204
(913) 367-2131
(913) 674-2024
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
43-558090
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016289120
PTAN
—
05
—
10028490401
—
NE
05
—
30004974080001
—
KS
05
—
910156011
—
MO
Enumeration date
04/17/2023
Last updated
03/19/2026
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