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Individual

SUSAN ANNETTE MCLANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 459-4785
(907) 459-4786
Mailing address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 459-4785
(907) 459-4786

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
NURR9654
AK

Other

Enumeration date
10/31/2018
Last updated
10/31/2018
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