Individual
MS. MARIA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
100 WALCO LN, MALVERN, AR 72104-6793
(501) 467-3400
Mailing address
8114 N HAVEN DR, ALEXANDER, AR 72002-2889
(501) 295-2527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A03596
AR
Other
Enumeration date
04/02/2007
Last updated
07/25/2012
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